Advanced age, male sex and comorbidities such as congestive heart failure increased in-hospital mortality among bariatric surgery recipients, although overall rates remained low, according to data presented at the Society of American Gastrointestinal and Endoscopic Surgeons Annual Meeting in Baltimore.
Researchers evaluated data on an estimated 548,106 bariatric procedures collected from the National Inpatient Sample database, performed between 2005 and 2009. Information on patient demographics, insurance status and comorbidities was collected, along with incidence of in-hospital morbidity and mortality.
The majority of procedures observed were laparoscopic Roux-en-Y gastric bypass (60.7%), followed by laparoscopic gastric banding (20.8%) and open gastric bypass (12.3%). Overall, in-hospital mortality occurred in 0.1% of cases, including 0.1% of those who received laparoscopic Roux-en-Y, 0% of laparoscopic gastric band recipients and 0.3% of open gastric bypass recipients. Sleeve gastrectomy accounted for 3.9% of procedures and had a 0.1% mortality rate, while laparoscopic gastroplasty accounted for 2.3% with a 0% mortality rate.
Multivariate analysis indicated associations between in-hospital mortality and several factors, including congestive heart failure (RR=5.4; 95% CI, 2.6-11.2), open procedures (RR=4.1; 95% CI, 3.3-5.0), age older than 50 years (RR=3.2; 95% CI, 2.5-4.0), male sex (RR=2.5; 95% CI, 1.5-4.0), obstructive sleep apnea (RR=2.4; 95% CI, 1.7-3.3) and chronic pulmonary disease (RR=2.3; 95% CI, 1.6-11.2).
“Operative mortality in bariatric surgery remains very low, rivaling that of more commonly accepted procedures (ie, laparoscopic cholecystectomy),” the researchers wrote. “Despite the many comorbidities associated with the morbidly obese patient, excellent outcomes can be achieved when these patients are managed appropriately. These outcomes speak to the level of maturity and dedication to quality patient care in the field of bariatric surgery.”
For more information:
Khan MA. S121: Factors Predicting In-Hospital Mortality in Bariatric Surgery: An Analysis From the National Inpatient Sample Database. Presented at: the Society of American Gastrointestinal and Endoscopic Surgeons 2013 Annual Meeting; April 17-20, Baltimore.