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Bariatric surgery associated with reduced long-term mortality risk

Tue, 08/18/2020 - 16:43
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Patients aged 55 years or older had a 48 percent lower risk for dying than matched patients who did not have surgery

A study of more than 26,000 patients has reported that bariatric surgery is associated with a lower risk for dying over the long-term, especially for heavier patients and those who have bariatric surgery at older ages. The outcomes were featured in the paper, ‘Association Between Bariatric Surgery and All-Cause Mortality: A Population-Based Matched Cohort Study in a Universal Health Care System’, published in the Annals of Internal Medicine.

Researchers from McMaster University and St Joseph's Healthcare Hamilton, Ontario, Canada, sought to determine the association between bariatric surgery and all-cause mortality. For the study, 13,679 patients with moderate to severe obesity who underwent bariatric surgery from January 2010 to December 2016 were compared to 13,679 matched non-surgical patients who were eligible for surgery but did not have it. They then compared the risk for dying over the long term between the two groups. They also examined whether the age, gender and BMI at the time of surgery had any impact on survival.

After a median follow-up of almost five years, the researchers found that the overall mortality rate was 1.4 percent (n=197)  in the surgery group and 2.5 percent (n=340) in the non-surgery group, with a lower adjusted hazard ratio of all-cause mortality (HR, 0.68 [95% CI, 0.57 to 0.81]). The difference in mortality risk was substantial among older adults and those who were heavier when they had bariatric surgery.

After measurable differences between patients who had surgery and those who did not were accounted for, patients aged 55 years or older had a 48 percent lower risk for dying than matched patients who didn't have surgery. Meanwhile, men and women derived essentially equal benefits and surgery also was associated with lower cardiovascular mortality (HR, 0.53 [CI, 0.34 to 0.84]) and lower cancer mortality (HR, 0.54 [CI, 0.36 to 0.80]).

According to the researchers, their study provides one of the most complete pictures of the association between bariatric surgery and mortality by delineating the specific effects among several important patient subgroups.

The primary funding source for this study was provide by the Ontario Bariatric Network.