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Bariatric surgery deemed as safe as other major surgeries

However, outcomes varied considerably based on patient characteristics, such as history of sleep apnea, venous thromboembolism

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Patients who had a first-time bariatric procedure had a low overall risk for death and adverse outcomes after 30 days.

The results of a prospective, multicenter, observational study suggest that the 30-day outcomes of patients who underwent a bariatric procedure are similar to other major surgeries.

The Longitudinal Assessment of Bariatric Surgery (LABS) Consortium examined outcomes in patients at 10 clinical sites in the United States who underwent a procedure from 2005 to 2007. Researchers identified 4,776 patients who underwent a first-time bariatric procedure (mean age, 44.5; mean BMI, 46.5; 21.1% men; 10.9% non-white). The majority of patients underwent Roux-en-Y gastric bypass (n=3,412; 87.2% laparoscopic) and laparoscopic adjustable gastric banding (n=1,198).

At day 30, the death rate among patients who underwent Roux-en-Y gastric bypass or laparoscopic adjustable gastric banding was 0.3% and 4.3% of patients had at least one major adverse outcome, including venous thromboembolism, reintervention or failure for discharge.

While the overall risk for death after bariatric surgery was low, other adverse outcomes “varied considerably according to patient characteristics,” according to the researchers. Patients with a history of deep vein thrombosis or pulmonary embolus, extreme values of BMI, sleep apnea and impaired functional status were each independently associated with increased risk for adverse outcomes.

“In helping patients make appropriate choices, short-term safety should be considered in conjunction with both the long-term effects of bariatric surgery and the risks associated with being extremely obese,” the researchers concluded.

According to the American Society for Metabolic and Bariatric Surgery, approximately 220,000 obesity surgeries were done in the United States last year. Gastric bypass is the most common method.

The Longitudinal Assessment of Bariatric Surgery Consortium. N Engl J Med. 2009;361:445-454.