Patients with obesity who underwent bariatric surgical procedures were less likely to die within a median period of about 4 years than those who managed obesity with usual means, according to a new study published in JAMA.
The findings provide a better understanding of the long-term outcomes of bariatric surgery, Orna Reges, PhD, of the Clalit Research Institute in Tel Aviv, Israel, and colleagues wrote.
“Bariatric surgery is an effective and safe approach for weight loss and short-term improvement in metabolic disorders, such as diabetes,” Reges told Healio Gastroenterology and Liver Disease. “However, there are few studies that have looked at the long-term consequences of such surgery.”
The researchers conducted a retrospective cohort study of 33,540 patients in Israel from the Clalit Health Service. The cohort included 8,385 patients who underwent bariatric surgery — including laparoscopic banding (n = 3,635), gastric bypass (n = 1,388) and laparoscopic sleeve gastrectomy (n = 3362) — and 25,155 nonsurgical patients.
There were 105 total deaths among the surgical patients (1.3%) during a median follow-up of 4.3 years, including 61 who underwent laparoscopic banding (1.7%), 18 who underwent gastric bypass (1.3%) and 26 who underwent laparoscopic sleeve gastrectomy (0.8%). During a median follow-up of 4 years, 583 nonsurgical patients (2.3%) died. The surgical group had 2.51 fewer deaths (95% CI, 1.63-3.15) per 1,000 patient-years compared with the nonsurgical group, according to the study.
Researchers also studied any long-term complications that arose from the three bariatric surgeries, and found that surgical patients had better outcomes than their nonsurgical counterparts.
“We were able to document lower mortality rates, of up to 50%, in the obese patients undergoing surgery as opposed to matched obese patients who continue with usual care,” Reges said. “In addition to the analyzed mortality data, exploratory data was also published and demonstrated the benefit of bariatric surgery with respect to BMI reduction, diabetes remission and incidence, and hypertension remission and incidence.” – by Alex Young
Disclosures: The authors report no relevant financial disclosures.