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Long-term mortality rates (>8-year) improve as compared to the general and obese population following bariatric surgery

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Abstract

Introduction

Sparse data are available on long-term patient mortality following bariatric surgery as compared to the general population. The purpose of this study was to assess long-term mortality rates and identify risk factors for all-cause mortality following bariatric surgery.

Methods

New York State (NYS) Planning and Research Cooperative System (SPARCS) longitudinal administrative data were used to identify 7,862 adult patients who underwent a primary laparoscopic bariatric surgery from 1999 to 2005. The Social Security Death Index database identified >30-day mortalities. Risk factors for mortality were screened using a univariate Cox proportional hazard (PH) model and analyzed using a multiple PH model. Based on age, gender, and race/ethnicity, actuarial projections for NYS mortality rates obtained from Centers of Disease Control were compared to the actual post-bariatric surgery mortality rates observed.

Results

The mean bariatric mortality rate was 2.5 % with 8–14 years of follow-up. Mean time to death ranged from 4 to 6 year and did not differ by operation (p = 0.073). From 1999 to 2010, the actuarial mortality rate predicted for the general NYS population was 2.1 % versus the observed 1.5 % for the bariatric surgery population (p = 0.005). Extrapolating to 2013, demonstrated the actuarial mortality predictions at 3.1 % versus the bariatric surgery patients’ observed morality rate of 2.5 % (p = 0.01). Risk factors associated with an earlier time to death included: age, male gender, Medicare/Medicaid insurance, congestive heart failure, rheumatoid arthritis, pulmonary circulation disorders, and diabetes. No procedure-specific or perioperative complication impact for time-to-death was found.

Conclusion

Long-term mortality rate of patients undergoing bariatric surgery significantly improves as compared to the general population regardless of bariatric operation performed. Additionally, perioperative complications do not increase long-term mortality risk. This study did identify specific patient risk factors for long-term mortality. Special attention and consideration should be given to these “at risk” patient sub-populations.

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References

  1. Ogden CL, Carroll MD, Kit BK, Flegal KM (2012) Prevalence of Obesity in the United States, 2009–2010. NCHS Data Brief 82:1–8

    PubMed  Google Scholar 

  2. Flegal KM, Graubard B, Williamson DF, Gail MH (2007) Cause-specific excess deaths associated with underweight, overweight, and obesity. JAMA 28(17):2028–2037

    Article  Google Scholar 

  3. Jee SH, Sull J, Park J et al (2006) Body mass index and mortality in Korean men and women. N Engl J Med 355:779–787

    Article  CAS  PubMed  Google Scholar 

  4. Adams KF, Schatzkin A, Harris TB et al (2006) Overweight, obesity, and mortality in a large prospective cohort of persons 50 to 71 years old. N Engl J Med 355:763–778

    Article  CAS  PubMed  Google Scholar 

  5. Yan LL, Daviglus M, Liu K et al (2006) Midlife body mass index and hospitalization and mortality in order age. JAMA 296:190–198

    Article  Google Scholar 

  6. Graubard B et al (2013) Association of all-cause mortality with overweight and obesity using standard body mass index categories, a systematic review and meta-analysis. JAMA 309(1):71–82

    Article  PubMed  Google Scholar 

  7. Sjostrom L, Peltonen M, Jacobson P et al (2012) Bariatric surgery and lot-term cardiovascular events. JAMA 307(1):56–65

    Article  PubMed  Google Scholar 

  8. Sjostrom L, Narbro K, Sjostrom CD et al (2007) Swedish Obese Subjects Study. Effects of bariatric surgery on Mortality in Swedish obese subjects. N Engl J Med 357(8):741–752

    Article  PubMed  Google Scholar 

  9. Christou NV, Sampalis J, Liberman M et al (2004) Surgery decreases long-term mortality, morbidity, and health care use in morbidly obese patients. Ann Surg 240:416–423

    Article  PubMed Central  PubMed  Google Scholar 

  10. Ballantyne GH (2003) Measuring outcomes following bariatric surgery: weight loss parameters, improvement in co-morbid conditions, change in quality of life and patient satisfaction. Obes Surg 13:954

    Article  PubMed  Google Scholar 

  11. Schauer PR, Kashyap SR, Wolski K et al (2012) Bariatric surgery versus intensive medical therapy in obese patients with diabetes. N Engl J Med 366:1567

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  12. Elixhauser A, Syeiner C, Harris D (1998) Co-morbidity measures for use with administrative data. Med Care 36:8–27

    Article  CAS  PubMed  Google Scholar 

  13. Social security death index. http://www.socialsecurity.gov/edds/EDR/EDRindex.htm

  14. CDC Wonder website. http://wonder.cdc.gov/controller/datarequest/D76

  15. Gao L, Matthews FE, Sargeant LA, Brayne C, CFAS MRC (2008) An investigation of the population impact of variation in HbA1c levels in older people in England and Wales: from a population based multi-centre longitudinal study. BMC Public Health 11(8):54

    Article  Google Scholar 

  16. Hu G, Qiao Q, Tuomilehto J et al (2004) Prevalence of the metabolic syndrome and its relation to all-cause and cardiovascular mortality in nondiabetic European men and women. Arch Intern Med 164:1066–1076

    Article  PubMed  Google Scholar 

  17. De Cosmo S, Copetti M, Lamacchia O, Fontana A, Massa M, Morini E, Pacilli A, Fariello S, Palena A, Rauseo A, Viti R, Di Paola R, Menzaghi C, Cignarelli M, Pellegrini F, Trischitta V (2013) Development and validation of a predicting model of all-cause mortality in patients with type 2 diabetes. Diabetes Care 36(9):2830–2835

    Article  PubMed Central  PubMed  Google Scholar 

  18. Adams TD, Gress RE, Smith SC, Halverson RC, Simper SC, Rosamond WD, Lemonte MJ, Stroup AM, Hunt AC (2007) Long-term mortality after gastric bypass surgery. N Engl J Med 357(8):753–761

    Article  CAS  PubMed  Google Scholar 

  19. Nguyen NT, Masoomi H, Laugenour K et al (2011) Predictive factors of mortality in bariatric surgery: data from the National Inpatient Sample. Surgery 150:347–351

    Article  PubMed  Google Scholar 

  20. Finks JF, Kole KL, Yenumula PR et al (2011) Predicting risk for serious complications with bariatric surgery: results from the Michigan Bariatric Surgery Collaborative. Ann Surg 254:633–640

    Article  PubMed  Google Scholar 

  21. DeMaria EJ, Murr M, Byrne TK, Blackstone R, Grant JP, Budak A, Wolfe L (2007) Validation of the obesity surgery mortality risk score in a multicenter study proves it stratifies mortality risk in patients undergoing gastric bypass for morbid obesity. Ann Surg 246(4):578–582

    Article  PubMed  Google Scholar 

  22. Ramanan B, Gupta PK, Gupta H, Fang X, Forse RA (2012) Development and validation of a bariatric surgery mortality risk calculator. J Am Coll Surg 214(6):892–900

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

We acknowledge the biostatistical consultation and support from the Biostatistical Consulting Core at the School of Medicine, Stony Brook University. We would also like to acknowledge Genia Dubrovsky BS, Lily Wang BA, and Richa Verma MD for assistance with data collection. And finally, Foster Gesten MD, Wendy Patterson MPH, and Brittany Peoples MS from the Office of Quality and Patient Safety in the New York State Department of Health in Albany, New York for assistance with data identification and extraction.

Disclosures

Drs. Talamini, Shroyer, Altieri and Yang and Mrs. Zhang have no financial disclosures. Dana A. Telem—Speaker for Novadaq and receives funding from the Fellowship Council. Aurora D. Pryor—has an ownership interest in Transenterix. She also is a speaker for and has research support from Novadaq. She receives fellowship funding from the Fellowship Council and is a consultant for Freehold Medical.

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Authors and Affiliations

  1. Division of Bariatric and Advanced Gastrointestinal Surgery, Department of Surgery, Stony Brook University Medical Center, 100 Nichols Road, HSC T18-040, Stony Brook, NY, 11794, USA

    Dana A. Telem, Mark Talamini, A. Laurie Shroyer, Maria Altieri, Gerald Gracia & Aurora D. Pryor

  2. Department of Preventative Medicine, Stony Brook University Medical Center, Stony Brook, NY, USA

    Jie Yang

  3. Department of Applied Mathematics and Statistics, Stony Brook University, Stony Brook, NY, USA

    Qiao Zhang

Authors
  1. Dana A. Telem
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  2. Mark Talamini
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  3. A. Laurie Shroyer
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  4. Jie Yang
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  5. Maria Altieri
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  6. Qiao Zhang
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  7. Gerald Gracia
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  8. Aurora D. Pryor
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Corresponding author

Correspondence to Dana A. Telem.

Additional information

Presented at the SAGES 2014 Annual Meeting, April 2–5, 2014, Salt Lake City, Utah.

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Telem, D.A., Talamini, M., Laurie Shroyer, A. et al. Long-term mortality rates (>8-year) improve as compared to the general and obese population following bariatric surgery. Surg Endosc 29, 529–536 (2015). https://doi.org/10.1007/s00464-014-3714-4

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  • DOI: https://doi.org/10.1007/s00464-014-3714-4

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