Bariatric Surgery Is Associated with a Reduced Risk of Mortality in Morbidly Obese Patients with a History of Major Cardiovascular Events

• Published in: The American surgeon Vol. 78; no. 6; pp. 685 - 692
• Main Authors: JOHNSON, Rebecca J, JOHNSON, Brent L, BLACKHURST, Dawn W, BOUR, Eric S, COBB, William S, CARBONELL, Alfredo M, LOKEY, Jonathan S, SCOTT, John D
• Format: Conference Proceeding Journal Article
• Language: English
• Published: Atlanta, GA Southeastern Surgical Congress 01.06.2012; SAGE PUBLICATIONS, INC
• Subjects: Adult; Aged; Bariatric Surgery; Biological and medical sciences; Cardiovascular disease; Cardiovascular Diseases - complications; Cardiovascular Diseases - epidemiology; Cause of Death - trends; Cholesterol; Epidemiology; Female; Follow-Up Studies; General aspects; Hospitalization; Hospitals; Humans; Male; Medical sciences; Middle Aged; Morbidity - trends; Mortality; Obesity; Obesity, Morbid - complications; Obesity, Morbid - surgery; Prognosis; Public health. Hygiene; Public health. Hygiene-occupational medicine; Retrospective Studies; Risk Assessment - methods; Risk Factors; South Carolina - epidemiology; Stomach, duodenum, intestine, rectum, anus; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the digestive system; Weight Loss; South Carolina; Human; Obesity; Mortality; Nutrition disorder; Bariatric surgery; Patient; Cardiovascular disease; Risk; Epidemiology; Medicine; Reduction; Association; Risk factor; Antecedent; Nutritional status
• ISSN: 0003-1348; 1555-9823
• DOI: 10.1177/000313481207800623

Although the safety of bariatric surgery in patients with established cardiovascular disease has been demonstrated, little is known about the mid- to long-term survival of these patients after surgery. We conducted a retrospective cohort study of bariatric surgical patients (n = 349) compared with morbidly obese surgical controls (n = 903). Data were obtained on all patients 40 to 79 years of age, from 1996 to 2008, with a diagnosis code of morbid obesity, a primary surgical procedure of interest, and a cardiovascular event history. Data sources were the statewide South Carolina UB92 inpatient hospitalization database and death records. The primary outcome was all-cause mortality. A total of 349 bariatric and 903 control patients with cardiovascular event histories were identified. Among bariatric patients, 19 deaths occurred in 986 person-years of follow-up versus 150 deaths among controls in 3138 person-years of follow-up. Unadjusted all-cause mortality was estimated at 7 ± 2 per cent at 5 years in bariatric patients compared with 19 ± 2 per cent (P < 0.001) in controls. Adjusting for age, comorbidities, and event history, the relative risk of mortality was reduced by 40 per cent in bariatric patients compared with controls [hazard ratios (95% confidence interval): 0.60 (0.36, 0.99)]. In patients with a history of cardiovascular events, bariatric surgery is associated with a significantly decreased risk of all-cause mortality.