Most followup studies of patients who had bariatric surgery focus on young women. A Seattle study of mostly male patients getting care at Veterans Affairs bariatric centers showed these patients, though older and with more risk factors than the female patients in many other studies, had lower death rates than obese patients who did not get the surgery.
Most follow-up studies of patients who had bariatric surgery focus on young women. A Seattle, WA, study of mostly male patients getting care at Veterans Affairs bariatric centers showed these patients, though older (average age 52) and with more risk factors than the female patients in many other studies, had lower death rates than a control group of obese patients who did not get the surgery.
In an article in the Journal of the American Medical Association, David Arterburn, MD, MPH, of the Group Health Research Institute in Seattle looked at long-term survival among 2,500 patients (75% men) who had the surgery at VA facilities and compared them to 7,462 obese patients who did not have the procedure.
Most of the surgery patients had gastric bypass (74%), sleeve gastrectomy (15%), or adjustable gastric banding (10 %). The remainder (1%) had other bariatric procedures.
At the end of the 14-year study period 233 surgery patients had died, compared to 1,277 in the control group.
Estimated mortality rates for the surgery group were 2.4% after 1 year, 6.4% after 5 years, and 13.8% at 10 years.
In the control group, mortality was lower in the first year (1.7%) but then it started to climb. At 5 years it was 10.4% and at 14 years it was 23.9%.
The surgery patients had an average body mass index (BMI) of 47 and the controls had a BMI of 46.
Arterburn noted that the study had limitations. Generally, the more bariatric procedures a surgeon does, the better patients will do. That holds true for bariatric centers. But because most VA surgeons are affiliated with university hospitals and operate in both settings, the researchers could not estimate surgical or institutional volume.
The study is important because the National Institutes of Health (NIH) has made getting better information on the long-term outcomes of bariatric surgery.
More than 15% of the US population is considered obese, with a BMI of 35 or higher and 6% are severely obese, with a BMI of 40 or higher.
"Our current study contributes to an increasing body of observational evidence that bariatric surgery is associated with better long-term survival than usual care," Arterburn wrote in the article.