Navigation Links
Bariatric surgery among older, high-risk patients not associated with reduced mortality
Date:6/12/2011

The use of bariatric surgery among older, severely obese patients was not associated with a decreased risk of death, according to a study in the June 15 issue of JAMA. This study is being released early online to coincide with its presentation at the AcademyHealth Annual Research Meeting.

"Obesity incidence has stabilized after decades of rapid increases, whereas the prevalence of patients with a body mass index [BMI] greater than 35 increased 39 percent between 2000 and 2005, the prevalence of severe obesity (BMI greater than 40) increased 50 percent, and the prevalence of superobesity (BMI greater than 50) increased 75 percent. Obesity is difficult to treat, and bariatric surgery is the most effective means to induce weight loss for the severely obese. Consequently, obesity surgery rates rapidly increased in tandem," according to background information in the article. "To date, no study to our knowledge has examined the long-term survival of high-risk patients who underwent bariatric surgery."

Matthew L. Maciejewski, Ph.D., of the Durham VA Medical Center, Durham, N.C., and colleagues conducted a study to determine whether bariatric surgery is associated with reduced mortality among predominantly older male high-risk patients at Veterans Affairs medical centers. Mortality was examined for 850 veterans who had bariatric surgery in January 2000 to December 2006 (average age 49.5 years; average BMI, 47.4) and 41,244 nonsurgical controls (average age 54.7 years; average BMI 42.0) from the same 12 Veteran Integrated Service Networks; the follow-up was through December 2008.

Eleven of 850 surgical case patients (1.29 percent) died within 30 days of surgery. The surgical case patients had lower crude mortality rates than the nonsurgical controls (at 1 year, 1.5 percent vs. 2.2 percent; at 2 years, 2.2 percent vs. 4.6 percent; at 6 years, 6.8 percent vs. 15.2 percent ). In unadjusted analysis, bariatric surgery was associated with reduced mortality. However, in further analysis that included 1,694 propensity-matched patients (using a statistical approach to compare patients who appear to be "similar" in many ways, except for one of the matched patients having had the operation), bariatric surgery was not significantly associated with reduced mortality.

"Our results highlight the importance of statistical adjustment and careful selection of surgical and nonsurgical cohorts, particularly during evaluation of bariatric surgery according to administrative data. Previous studies claiming a survival benefit for bariatric surgery had limited clinical information to conduct detailed risk adjustment or matching. The survival differences between the bariatric surgery and control groups were modest in most previous studies, so the beneficial effects of surgery may have been attenuated if adjustment for confounders had been possible. We demonstrated that risk adjustment with regression analysis resulted in a significant association of surgery and survival that was reduced when equivalence in baseline characteristics improved via propensity matching in this high-risk patient group," the authors write.

The researchers add that even though bariatric surgery is not associated with reduced mortality among older male patients, many patients may still choose to undergo bariatric surgery, given the strong evidence for significant reductions in body weight and co-existing illnesses and improved quality of life.


'/>"/>

Contact: Pete Tillman
Peter.Tillman@va.gov
919-286-6986
JAMA and Archives Journals
Source:Eurekalert

Related medicine news :

1. Bariatric surgery linked to increased fracture risk
2. In trial, video helps people weigh bariatric surgery pros, cons
3. New tool helps surgeons predict patients risk of complications after bariatric operations
4. Bariatric surgery reduces long-term cardiovascular risk in diabetes patients
5. Bariatric surgery highly cost-effective treatment for type 2 diabetes in the obese
6. Experts issue recommendations for treatment of post-bariatric surgery patients
7. Honolulu, Hawaii Bariatric Surgery Practice Launches New Website to Reach Out to Patients Fighting Morbid Obesity
8. Eisner USA, LLC Collaborates with Surgical Review Corp to Provide Innovative Bariatric Devices to Bariatric Surgery Center of Excellence (BSCOE) Participants
9. QuickMedical Launches New Line of Medical Equipment for Bariatric Care
10. Bariatricfurnishings.com Launches Unique Eco-friendly Seating for Health Care, Hospitality, Assisted Living Centers, and Home Use at Competitive Prices
11. Hypnosis/local anesthesia combination during surgery helps patients, reduces hospital stays
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:10/13/2017)... ... ... “The Journey: From the Mountains to the Mission Field”: the story of a ... “The Journey: From the Mountains to the Mission Field” is the creation of published ... all ages and currently teaches a class of ladies at her church, which she ...
(Date:10/12/2017)... ... October 12, 2017 , ... CitiDent and ... apnea using cutting-edge Oventus O2Vent technology. As many as 18 million Americans ... frequent cessation in breathing. Oral appliances can offer significant relief to about 75 ...
(Date:10/12/2017)... ... October 12, 2017 , ... IsoComforter, Inc. ( ... today the introduction of an innovative new design of the shoulder pad. The ... get maximum comfort while controlling your pain while using cold therapy. By utilizing ice ...
(Date:10/12/2017)... ... October 12, 2017 , ... Information about the technology: ... develop to enable prevention of a major side effect of chemotherapy in children. ... pediatric patients. For cisplatin, hearing loss is FDA listed on-label as a dose ...
(Date:10/12/2017)... D.C. (PRWEB) , ... October 12, 2017 , ... Leading ... their peers in Washington, D.C., for the 49th Congress of the International Society ... ., Vice President of the Center for Cancer and Blood Disorders at ...
Breaking Medicine News(10 mins):
(Date:10/12/2017)... West Pharmaceutical Services, Inc. (NYSE: ... drug administration, today announced that it will release third-quarter ... October 26, 2017, and will follow with a conference ... 9:00 a.m. Eastern Time. To participate on the call, ... ID is 94093362. ...
(Date:10/11/2017)... , Oct. 11, 2017  True Health, a ... amplified its effort during National Breast Cancer Awareness ... cancer risks. ... Oncology calculated that more than 10 million American ... mutations in BRCA1 or BRCA2 and have not had ...
(Date:10/10/2017)... 10, 2017   West Pharmaceutical Services, Inc. ... injectable drug administration, today shared the results of a ... improving the intradermal administration of polio vaccines. The study ... in May 2017 by Dr. Ondrej Mach , ... Health Organization (WHO), and recently published in the journal ...
Breaking Medicine Technology: