Suicide, coronary heart disease contribute to increased risk of death following bariatric surgery

October 15, 2007

Approximately 1 percent of Pennsylvania residents who underwent bariatric surgery between 1995 and 2004 died within one year of the surgery and nearly 6 percent died within five years, according to a report in the October issue of Archives of Surgery, a theme issue on bariatric surgery. Death rates overall, as well as deaths from heart disease and suicide, were higher than those of the general state population.

Bariatric surgery has emerged as an effective treatment for severe obesity, according to background information in the article. Obese individuals typically lose up to 80 percent of their excess body weight one to two years after the operation. "Bariatric surgery results in clinical improvement and resolution of the obesity-related comorbid diseases," the authors write, including diabetes, high blood pressure and high cholesterol.

Bennet I. Omalu, M.D., M.P.H., of the University of Pittsburgh, and colleagues analyzed data on all bariatric operations performed on Pennsylvania residents between 1995 and 2004. Following 16,683 operations, 440 patients (2.6 percent) died.

"Age- and sex-specific death rates after bariatric surgery were substantially higher than comparable rates for the age- and sex-matched Pennsylvania population," the authors write. "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 researchers found that: "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," the authors conclude.
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(Arch Surg. 2007;142(10):923-928. Available pre-embargo to the media at www.jamamedia.org.)

Editor's Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

The JAMA Network Journals

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