ARM: Bariatric Surgery Not Linked to Reduced Mortality

Bariatric surgery may not significantly reduce mortality rates in severely obese older patients

MONDAY, June 13 (HealthDay News) -- Bariatric surgery is not associated with significantly reduced mortality in severely obese older patients with high baseline mortality, according to a study published online June 12 in the Journal of the American Medical Association, to coincide with its presentation at the AcademyHealth Annual Research Meeting, held from June 12 to 14 in Seattle.

Matthew L. Maciejewski, Ph.D., from the Durham Veterans Affairs Medical Center in North Carolina, and colleagues investigated whether bariatric surgery was associated with reduced mortality in 850 predominantly male veterans (average age of 49.5 years and average body mass index of 47.4 kg/m²) with high baseline mortality. Participants underwent bariatric surgery between 2000 and 2006, and results were compared with 41,244 nonsurgical controls. Participants were followed up for an average 6.7 years, during which time crude mortality rates were compared between groups, and all-cause mortality was examined in unmatched and propensity-matched cohorts with and without multivariable adjustment.

The investigators found that crude mortality rates at one, two, and six years for surgical patients were 1.5, 2.2, and 6.8 percent, respectively, compared to 2.2, 4.6, and 15.2 percent, respectively, for nonsurgical controls. In an unadjusted analysis, bariatric surgery was significantly correlated with reduced mortality (hazard ratio [HR], 0.64). The association persisted after multivariable adjustment (HR, 0.80). However, in analysis of 1,694 propensity-matched patients, the association was attenuated in both unadjusted (HR, 0.83; 95 percent confidence interval [CI], 0.61 to 1.14) and time-adjusted (HR, 0.94; 95 percent CI, 0.64 to 1.39) analyses.

"These results suggest that bariatric surgery is not associated with reduced mortality among older men within a few years after surgery," the authors write.

Two authors disclosed financial relationships with the pharmaceutical and medical device industry, and one of the study authors disclosed an indirect financial relationship with a health care company.

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