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

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