Superobesity Associated with Risk of Death Following Bariatric Surgery

Those classified as superobese and those with a higher chronic disease burden appear more likely to die within a year of having bariatric surgery, according to a new study.

Researchers at the University of Washington (Seattle, USA), the University of Colorado (Boulder, USA), the U.S. department of Veterans Affairs (VA; Washington, DC, USA), and other institutions examined patient factors associated with the risk of death among 856 veterans who underwent bariatric surgery in any of 12 VA bariatric centers from 2000 to 2006; the patients had an average body mass index (BMI) of 48.7, an average age of 54 years, and 73% were men. The researchers found that overall, a total of 54 patients (6.3%) died during the follow-up period; 1.3% of the patients died 30 days after surgery, 2.1% died 90 days after surgery, and 3.4% had died after one year. In statistical models performed by the researchers, the patients who were classified as superobese--those having a BMI of 50 or higher, representing 36% of the sample--and those with a higher score on a measure of costs related to co-occurring diseases (8% of the sample) had an increased risk of death. The superobese patients, who accounted for 30 deaths, had 30-day, 90-day, and one-year death rates of 2.0%, 3.6%, and 5.2%, whereas those with a higher comorbidity cost score had rates of 1.5%, 5.8%, and 10.1%, respectively. The study was published in the October 2009 issue of Archives of Surgery.

"The results of this study should inform discussions with patients with regard to the potential risks and benefits of bariatric surgery,” concluded lead author David Arterburn, M.D., M.P.H., of the University of Washington and the Group Health Research Institute (Seattle, USA), and colleagues. "These findings also suggest that the risks of bariatric surgery in patients with significant comorbidities, such as congestive heart failure, complicated diabetes, and chronic obstructive pulmonary disease, should be carefully weighed against potential benefits in older male patients and those with superobesity.”

Bariatric surgery is one of the few interventions that can help morbidly obese individuals lose enough weight to significantly improve their health and quality of life. However, while the risk of death associated with bariatric surgery is traditionally thought to be low, most previous studies have involved younger women, rather than the older male population that typically uses VA facilities.

Related Links:
University of Washington
University of Colorado
U.S. department of Veterans Affairs
Group Health Research Institute