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Mortality risk decreased after bariatric surgery
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Patients with obesity who undergo bariatric surgery have a lower risk for mortality compared with those who do not undergo surgery, according to recent study findings published in JAMA.
“The main implication of our study is that clinicians and patients with severe obesity can have greater confidence that bariatric surgical procedures are association with better long-term survival than not having surgery,” David E. Arterburn, MD, MPH, of the Group Health Research Institute in Seattle, told Endocrine Today. “Prior studies have demonstrated this findings in younger, predominately female population, but our study confirms this finding in an older, predominantly male cohort, with multiple comorbid health problems.”
David E. Arterburn
Arterburn and colleagues evaluated 2,500 adults who underwent bariatric surgery, as well as 7,462 matched controls managed without surgery, to determine the effect of bariatric surgery on long-term survival.
Gastric bypass was the most commonly performed procedure (74%), followed by sleeve gastrectomy (15%), adjustable gastric banding (10%) and other (1%).
“We also found evidence that bariatric surgery has become safer,” study researcher Matthew Maciejewski, PhD, of the Durham VA Medical Center and the Duke University School of Medicine, said in the release. “We found that the risk of dying during and soon after bariatric surgery was lower in 2006-2011 than in 2000-2005.”
Hypertension, dyslipidemia, arthritis, depression, gastroesophageal reflux disease and fatty liver disease were more common in the surgical group compared with controls, whereas schizophrenia and alcohol abuse disorders were less common.
“We have tracked a large group of patients for a long time that we can clearly see a strong link between bariatric surgery and long-term survival,” Arterburn said in the release. “As time passes, the risk of dying among the patients who’ve had surgery appears to be diverging from those of the matched controls who haven’t had surgery.”
More deaths occurred within the control group (n=1,277) vs. the surgical group (n=263) at the end of the 14-year study. In the first year of follow-up, bariatric surgery was not associated with all-cause mortality (HR=1.28; 95% CI, 0.98-1.68), but there was a lower mortality after 1 to 5 “Our results may have broader implications for encouraging weight loss in general,” Arterburn said in the release. “Despite the studies showing that patients with lower BMI live longer, not much evidence has linked intentional weight loss (from surgery, medication or diet and exercise) with longer survival. But our results, combined with other studies of bariatric surgery, may help to make that case.” -by Amber Cox
For more information:
David E. Arterburn, MD, MPH, can be reached at Metropolitan Park East, 1730 Minor Avenue, Ste. 1600, Seattle, WA 98101; email: Arterburn.d@ghc.org.
Disclosure: See the full study for a complete list of the researchers’ relevant financial disclosures.
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