Bariatric Surgery Risk Greater Than Thought

A study of more than 16,000 patients 65 and over has shown that the risk of early death after bariatric surgery is considerably higher than previously suggested and may be associated with advancing age, male sex, and a low surgeon volume of procedures.

Bariatric surgery is the only intervention that consistently helps patients achieve and sustain weight loss and improvements in related medical conditions. This has resulted in a dramatic growth in this type of surgery, as revealed in a second study of trends in bariatric surgery, led by Dr. Heena P. Santry, department of surgery at the University of Chicago (IL, USA). From 1998 to 2002, the number of elective procedures rose from 13,365 to 72,177. Meanwhile, the risks have been poorly defined. High-profile users whose procedures ended in death after the surgery have now sparked a critical reappraisal of the safety of bariatric surgery.

Lead author of the first study, David R. Flum, M.D., M.P.H., department of surgery, University of Washington (Seattle, USA), revealed that skepticism is warranted. Patients 65 and over in his study had a substantially higher risk of death within the early postoperative period than younger patients. Men had higher rates of early death than women, and the odds of death within 90 days were five-fold greater for patients over 75 than for those 65-74. Also, the odds of death at 90 days were 1.6 times higher for patients of surgeons with less than the median surgical volume of bariatric procedures.

"The risk of death is much higher than has been reported,” observed Dr. Flum.

A third study, by Dr. David Zingmond of the University of California at Los Angeles (USA), has shown that increases in hospital use appear to be related to the Roux-en-Y gastric bypass procedure. All three studies were published in the October 19, 2005, issue of the Journal of the American Medical Association.




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