In Pennsylvania 1% of patients who underwent bariatric surgery during the period 1995-2004 died within 12 months, while over 6% died within five years, according to an article in Archives of Surgery, October issue (theme issue on bariatric surgery). Deaths from suicide and heart disease, as well as death rates overall were higher that that seen for the general state population.

Patients who undergo bariatric surgery generally shed up to 80% of their surplus body weight within 12 to 24 months after the operation – it has emerged as an effective treatment for severe obesity, explain the authors. “Bariatric surgery results in clinical improvement and resolution of the obesity-related comorbid diseases.”

Bennet I. Omalu, M.D., M.P.H., University of Pittsburgh, and team looked at data regarding all bariatric operations carried out on Pennsylvania residents during the period 1995-2004. Out of a total of 16,683 operations 2.6% (440) of the patients died.

“Age- and sex-specific death rates after bariatric surgery were substantially higher than comparable rates for the age- and sex-matched Pennsylvania population. This continued high mortality rate is likely a function of the initial comorbidities related to substantial obesity and the likelihood that the patients remain obese even after the substantial weight loss and have remaining comorbidities,” the writers explain.

The scientists found that:

— Less than 1% of the deaths happened with 30 days after surgery

— About 1% of patients had died within 12 months after surgery

— 6.4% of patients had died within five years after surgery (cumulative case fatality)

— The older the patients the higher their death rate, especially those older than 65 (the average age for surgery was 48 years)

— The leading cause of death was heart disease. Rates of death from heart disease among bariatric surgery patients was higher than in the general population

— Of 45 deaths from traumatic causes 4% (16) of them were suicides, while 3% (14) were drug overdoses which were not classified as suicides. Only two suicide deaths would have been expected if one based this on national statistics for the general population

The authors conclude “It is likely that this continued excess mortality after bariatric surgery could be reduced by better coordination of follow-up after the surgery, especially control of high risk factors such as hypertension, diabetes mellitus, hyperlipidemia [high cholesterol] and smoking, as well as efforts to prevent weight regain by diet and exercise and psychological support to prevent and treat depression and suicide.”

“Death Rates and Causes of Death After Bariatric Surgery for Pennsylvania Residents, 1995 to 2004”
Bennet I. Omalu, MD, MPH; Diane G. Ives, MPH; Alhaji M. Buhari, MA, MSIE; Jennifer L. Lindner, DO; Philip R. Schauer, MD; Cyril H. Wecht, MD, JD; Lewis H. Kuller, MD, DrPH
Arch Surg. 2007;142:923-928.
Click here to see abstract online

Written by: Christian Nordqvist