Long-term mortality in obese subjects undergoing malabsorptive surgery (biliopancreatic diversion and biliointestinal bypass) versus medical treatment

Background and aim Aim of this study was to analyze long-term mortality in obese patients receiving malabsorptive bariatric surgery (BS)[biliopancreatic diversion (BPD) and biliointestinal bypass (BIBP)] in comparison to medical treatment of obesity. Patients and methods Medical records of 1877 obes...

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Published inInternational Journal of Obesity Vol. 43; no. 6; pp. 1147 - 1153
Main Authors Ceriani, Valerio, Sarro, Giuliano, Micheletto, Giancarlo, Giovanelli, Alessandro, Zakaria, Ahmed S., Fanchini, Marco, Osio, Chiara, Nosari, Italo, Morabito, Alberto, Pontiroli, Antonio E.
Format Journal Article
LanguageEnglish
Published London Nature Publishing Group UK 01.06.2019
Nature Publishing Group
Subjects
692/308/174
692/700/565/545/2098
Adult
Bariatric Surgery - mortality
Blood pressure
Body mass index
Body size
Body weight loss
Cancer
Cardiovascular diseases
Care and treatment
Cause of Death
Conservative Treatment - mortality
Diabetes
Diabetes mellitus
Epidemiology
Female
Gastrointestinal surgery
Health Care Surveys
Health Promotion and Disease Prevention
Health services
Humans
Internal Medicine
Male
Medical records
Medical treatment
Medicine
Medicine & Public Health
Metabolic Diseases
Middle Aged
Mortality
Obesity
Obesity, Morbid - mortality
Obesity, Morbid - therapy
Overweight persons
Patients
Public Health
Regression analysis
Surgery
Survival Rate
Weight Loss - physiology
Young Adult
Italy
Online AccessGet full text
ISSN0307-0565
1476-5497
1476-5497
DOI10.1038/s41366-018-0244-5

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Abstract Background and aim Aim of this study was to analyze long-term mortality in obese patients receiving malabsorptive bariatric surgery (BS)[biliopancreatic diversion (BPD) and biliointestinal bypass (BIBP)] in comparison to medical treatment of obesity. Patients and methods Medical records of 1877 obese patients [body mass index (BMI) > 35 kg/m 2 , aged 18–65 years, undergoing BS ( n  = 472, 111 with diabetes) or non-surgical medical treatment ( n  = 1405, 385 with diabetes), during the period 1999–2008 (visit 1)] were collected; non-surgical patients were matched for age, sex, BMI, and blood pressure, and life status and causes of death were ascertained through December 2016. Survival was compared across surgery patients and non-surgical patients using Kaplan–Meier plots and Cox regression analyses. Results Observation period was 12.1 ± 3.41 years (mean ± SD). Compared to non-surgical patients, BS patients had reduced all-cause mortality (34/472 (7.2%) vs 181/1,405 (12.9%) patients, χ 2  = 11.25, p  = 0.001; HR = 0.64, 95% C.I. 0.43–0.93, p  = 0.019). Cardiovascular and cancer causes of death were significantly less frequent in surgery vs no-surgery (HR = 0.26, 95% C.I. 0.09–0.72, p  = 0.003; HR = 0.21, 95% C.I. 0.09–0.45, p  < 0.001, respectively). Conclusion Patients who have undergone BPD and BIBP have lower long-term all-cause, cardiovascular-caused and cancer-caused mortality compared to non-surgical medical weight-loss treatment patients. Malabsorptive bariatric surgery significantly reduces long-term mortality in severely obese patients.
AbstractList Medical records of 1877 obese patients [body mass index (BMI) > 35 kg/m.sup.2, aged 18-65 years, undergoing BS (n = 472, 111 with diabetes) or non-surgical medical treatment (n = 1405, 385 with diabetes), during the period 1999-2008 (visit 1)] were collected; non-surgical patients were matched for age, sex, BMI, and blood pressure, and life status and causes of death were ascertained through December 2016. Survival was compared across surgery patients and non-surgical patients using Kaplan-Meier plots and Cox regression analyses. Observation period was 12.1 [plus or minus] 3.41 years (mean [plus or minus] SD). Compared to non-surgical patients, BS patients had reduced all-cause mortality (34/472 (7.2%) vs 181/1,405 (12.9%) patients, [chi].sup.2 = 11.25, p = 0.001; HR = 0.64, 95% C.I. 0.43-0.93, p = 0.019). Cardiovascular and cancer causes of death were significantly less frequent in surgery vs no-surgery (HR = 0.26, 95% C.I. 0.09-0.72, p = 0.003; HR = 0.21, 95% C.I. 0.09-0.45, p < 0.001, respectively).
Background and aim Aim of this study was to analyze long-term mortality in obese patients receiving malabsorptive bariatric surgery (BS)[biliopancreatic diversion (BPD) and biliointestinal bypass (BIBP)] in comparison to medical treatment of obesity. Patients and methods Medical records of 1877 obese patients [body mass index (BMI) > 35 kg/m.sup.2, aged 18-65 years, undergoing BS (n = 472, 111 with diabetes) or non-surgical medical treatment (n = 1405, 385 with diabetes), during the period 1999-2008 (visit 1)] were collected; non-surgical patients were matched for age, sex, BMI, and blood pressure, and life status and causes of death were ascertained through December 2016. Survival was compared across surgery patients and non-surgical patients using Kaplan-Meier plots and Cox regression analyses. Results Observation period was 12.1 [plus or minus] 3.41 years (mean [plus or minus] SD). Compared to non-surgical patients, BS patients had reduced all-cause mortality (34/472 (7.2%) vs 181/1,405 (12.9%) patients, [chi].sup.2 = 11.25, p = 0.001; HR = 0.64, 95% C.I. 0.43-0.93, p = 0.019). Cardiovascular and cancer causes of death were significantly less frequent in surgery vs no-surgery (HR = 0.26, 95% C.I. 0.09-0.72, p = 0.003; HR = 0.21, 95% C.I. 0.09-0.45, p < 0.001, respectively). Conclusion Patients who have undergone BPD and BIBP have lower long-term all-cause, cardiovascular-caused and cancer-caused mortality compared to non-surgical medical weight-loss treatment patients. Malabsorptive bariatric surgery significantly reduces long-term mortality in severely obese patients.
Aim of this study was to analyze long-term mortality in obese patients receiving malabsorptive bariatric surgery (BS)[biliopancreatic diversion (BPD) and biliointestinal bypass (BIBP)] in comparison to medical treatment of obesity.BACKGROUND AND AIMAim of this study was to analyze long-term mortality in obese patients receiving malabsorptive bariatric surgery (BS)[biliopancreatic diversion (BPD) and biliointestinal bypass (BIBP)] in comparison to medical treatment of obesity.Medical records of 1877 obese patients [body mass index (BMI) > 35 kg/m2, aged 18-65 years, undergoing BS (n = 472, 111 with diabetes) or non-surgical medical treatment (n = 1405, 385 with diabetes), during the period 1999-2008 (visit 1)] were collected; non-surgical patients were matched for age, sex, BMI, and blood pressure, and life status and causes of death were ascertained through December 2016. Survival was compared across surgery patients and non-surgical patients using Kaplan-Meier plots and Cox regression analyses.PATIENTS AND METHODSMedical records of 1877 obese patients [body mass index (BMI) > 35 kg/m2, aged 18-65 years, undergoing BS (n = 472, 111 with diabetes) or non-surgical medical treatment (n = 1405, 385 with diabetes), during the period 1999-2008 (visit 1)] were collected; non-surgical patients were matched for age, sex, BMI, and blood pressure, and life status and causes of death were ascertained through December 2016. Survival was compared across surgery patients and non-surgical patients using Kaplan-Meier plots and Cox regression analyses.Observation period was 12.1 ± 3.41 years (mean ± SD). Compared to non-surgical patients, BS patients had reduced all-cause mortality (34/472 (7.2%) vs 181/1,405 (12.9%) patients, χ2 = 11.25, p = 0.001; HR = 0.64, 95% C.I. 0.43-0.93, p = 0.019). Cardiovascular and cancer causes of death were significantly less frequent in surgery vs no-surgery (HR = 0.26, 95% C.I. 0.09-0.72, p = 0.003; HR = 0.21, 95% C.I. 0.09-0.45, p < 0.001, respectively).RESULTSObservation period was 12.1 ± 3.41 years (mean ± SD). Compared to non-surgical patients, BS patients had reduced all-cause mortality (34/472 (7.2%) vs 181/1,405 (12.9%) patients, χ2 = 11.25, p = 0.001; HR = 0.64, 95% C.I. 0.43-0.93, p = 0.019). Cardiovascular and cancer causes of death were significantly less frequent in surgery vs no-surgery (HR = 0.26, 95% C.I. 0.09-0.72, p = 0.003; HR = 0.21, 95% C.I. 0.09-0.45, p < 0.001, respectively).Patients who have undergone BPD and BIBP have lower long-term all-cause, cardiovascular-caused and cancer-caused mortality compared to non-surgical medical weight-loss treatment patients. Malabsorptive bariatric surgery significantly reduces long-term mortality in severely obese patients.CONCLUSIONPatients who have undergone BPD and BIBP have lower long-term all-cause, cardiovascular-caused and cancer-caused mortality compared to non-surgical medical weight-loss treatment patients. Malabsorptive bariatric surgery significantly reduces long-term mortality in severely obese patients.
Background and aim Aim of this study was to analyze long-term mortality in obese patients receiving malabsorptive bariatric surgery (BS)[biliopancreatic diversion (BPD) and biliointestinal bypass (BIBP)] in comparison to medical treatment of obesity. Patients and methods Medical records of 1877 obese patients [body mass index (BMI) > 35 kg/m 2 , aged 18–65 years, undergoing BS ( n  = 472, 111 with diabetes) or non-surgical medical treatment ( n  = 1405, 385 with diabetes), during the period 1999–2008 (visit 1)] were collected; non-surgical patients were matched for age, sex, BMI, and blood pressure, and life status and causes of death were ascertained through December 2016. Survival was compared across surgery patients and non-surgical patients using Kaplan–Meier plots and Cox regression analyses. Results Observation period was 12.1 ± 3.41 years (mean ± SD). Compared to non-surgical patients, BS patients had reduced all-cause mortality (34/472 (7.2%) vs 181/1,405 (12.9%) patients, χ 2  = 11.25, p  = 0.001; HR = 0.64, 95% C.I. 0.43–0.93, p  = 0.019). Cardiovascular and cancer causes of death were significantly less frequent in surgery vs no-surgery (HR = 0.26, 95% C.I. 0.09–0.72, p  = 0.003; HR = 0.21, 95% C.I. 0.09–0.45, p  < 0.001, respectively). Conclusion Patients who have undergone BPD and BIBP have lower long-term all-cause, cardiovascular-caused and cancer-caused mortality compared to non-surgical medical weight-loss treatment patients. Malabsorptive bariatric surgery significantly reduces long-term mortality in severely obese patients.
Background and aimAim of this study was to analyze long-term mortality in obese patients receiving malabsorptive bariatric surgery (BS)[biliopancreatic diversion (BPD) and biliointestinal bypass (BIBP)] in comparison to medical treatment of obesity.Patients and methodsMedical records of 1877 obese patients [body mass index (BMI) > 35 kg/m2, aged 18–65 years, undergoing BS (n = 472, 111 with diabetes) or non-surgical medical treatment (n = 1405, 385 with diabetes), during the period 1999–2008 (visit 1)] were collected; non-surgical patients were matched for age, sex, BMI, and blood pressure, and life status and causes of death were ascertained through December 2016. Survival was compared across surgery patients and non-surgical patients using Kaplan–Meier plots and Cox regression analyses.ResultsObservation period was 12.1 ± 3.41 years (mean ± SD). Compared to non-surgical patients, BS patients had reduced all-cause mortality (34/472 (7.2%) vs 181/1,405 (12.9%) patients, χ2 = 11.25, p = 0.001; HR = 0.64, 95% C.I. 0.43–0.93, p = 0.019). Cardiovascular and cancer causes of death were significantly less frequent in surgery vs no-surgery (HR = 0.26, 95% C.I. 0.09–0.72, p = 0.003; HR = 0.21, 95% C.I. 0.09–0.45, p < 0.001, respectively).ConclusionPatients who have undergone BPD and BIBP have lower long-term all-cause, cardiovascular-caused and cancer-caused mortality compared to non-surgical medical weight-loss treatment patients. Malabsorptive bariatric surgery significantly reduces long-term mortality in severely obese patients.
Aim of this study was to analyze long-term mortality in obese patients receiving malabsorptive bariatric surgery (BS)[biliopancreatic diversion (BPD) and biliointestinal bypass (BIBP)] in comparison to medical treatment of obesity. Medical records of 1877 obese patients [body mass index (BMI) > 35 kg/m , aged 18-65 years, undergoing BS (n = 472, 111 with diabetes) or non-surgical medical treatment (n = 1405, 385 with diabetes), during the period 1999-2008 (visit 1)] were collected; non-surgical patients were matched for age, sex, BMI, and blood pressure, and life status and causes of death were ascertained through December 2016. Survival was compared across surgery patients and non-surgical patients using Kaplan-Meier plots and Cox regression analyses. Observation period was 12.1 ± 3.41 years (mean ± SD). Compared to non-surgical patients, BS patients had reduced all-cause mortality (34/472 (7.2%) vs 181/1,405 (12.9%) patients, χ  = 11.25, p = 0.001; HR = 0.64, 95% C.I. 0.43-0.93, p = 0.019). Cardiovascular and cancer causes of death were significantly less frequent in surgery vs no-surgery (HR = 0.26, 95% C.I. 0.09-0.72, p = 0.003; HR = 0.21, 95% C.I. 0.09-0.45, p < 0.001, respectively). Patients who have undergone BPD and BIBP have lower long-term all-cause, cardiovascular-caused and cancer-caused mortality compared to non-surgical medical weight-loss treatment patients. Malabsorptive bariatric surgery significantly reduces long-term mortality in severely obese patients.
Audience Academic
Author Nosari, Italo
Fanchini, Marco
Sarro, Giuliano
Ceriani, Valerio
Micheletto, Giancarlo
Morabito, Alberto
Pontiroli, Antonio E.
Osio, Chiara
Giovanelli, Alessandro
Zakaria, Ahmed S.
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BackLink https://www.ncbi.nlm.nih.gov/pubmed/30470806$$D View this record in MEDLINE/PubMed
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PublicationSubtitle Official journal of the International Association for the Study of Obesity
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Snippet Background and aim Aim of this study was to analyze long-term mortality in obese patients receiving malabsorptive bariatric surgery (BS)[biliopancreatic...
Aim of this study was to analyze long-term mortality in obese patients receiving malabsorptive bariatric surgery (BS)[biliopancreatic diversion (BPD) and...
Background and aim Aim of this study was to analyze long-term mortality in obese patients receiving malabsorptive bariatric surgery (BS)[biliopancreatic...
Medical records of 1877 obese patients [body mass index (BMI) > 35 kg/m.sup.2, aged 18-65 years, undergoing BS (n = 472, 111 with diabetes) or non-surgical...
Background and aimAim of this study was to analyze long-term mortality in obese patients receiving malabsorptive bariatric surgery (BS)[biliopancreatic...
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StartPage 1147
SubjectTerms 692/308/174
692/700/565/545/2098
Adult
Bariatric Surgery - mortality
Blood pressure
Body mass index
Body size
Body weight loss
Cancer
Cardiovascular diseases
Care and treatment
Cause of Death
Conservative Treatment - mortality
Diabetes
Diabetes mellitus
Epidemiology
Female
Gastrointestinal surgery
Health Care Surveys
Health Promotion and Disease Prevention
Health services
Humans
Internal Medicine
Male
Medical records
Medical treatment
Medicine
Medicine & Public Health
Metabolic Diseases
Middle Aged
Mortality
Obesity
Obesity, Morbid - mortality
Obesity, Morbid - therapy
Overweight persons
Patients
Public Health
Regression analysis
Surgery
Survival Rate
Weight Loss - physiology
Young Adult
Title Long-term mortality in obese subjects undergoing malabsorptive surgery (biliopancreatic diversion and biliointestinal bypass) versus medical treatment
URI https://link.springer.com/article/10.1038/s41366-018-0244-5
https://www.ncbi.nlm.nih.gov/pubmed/30470806
https://www.proquest.com/docview/2235044344
https://www.proquest.com/docview/2137470088
Volume 43
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