Long-term mortality rates (>8-year) improve as compared to the general and obese population following bariatric surgery

Dana A. Telem, Mark Talamini, A. Laurie Shroyer, Jie Yang, Maria Altieri, Qiao Zhang, Gerald Gracia, Aurora D. Pryor

Research output: Contribution to journalArticle

Abstract

INTRODUCTION: Sparse data are available on long-term patient mortality following bariatric surgery as compared to the general population. The purpose of this study was to assess long-term mortality rates and identify risk factors for all-cause mortality following bariatric surgery.

METHODS: New York State (NYS) Planning and Research Cooperative System (SPARCS) longitudinal administrative data were used to identify 7,862 adult patients who underwent a primary laparoscopic bariatric surgery from 1999 to 2005. The Social Security Death Index database identified >30-day mortalities. Risk factors for mortality were screened using a univariate Cox proportional hazard (PH) model and analyzed using a multiple PH model. Based on age, gender, and race/ethnicity, actuarial projections for NYS mortality rates obtained from Centers of Disease Control were compared to the actual post-bariatric surgery mortality rates observed.

RESULTS: The mean bariatric mortality rate was 2.5 % with 8-14 years of follow-up. Mean time to death ranged from 4 to 6 year and did not differ by operation (p = 0.073). From 1999 to 2010, the actuarial mortality rate predicted for the general NYS population was 2.1 % versus the observed 1.5 % for the bariatric surgery population (p = 0.005). Extrapolating to 2013, demonstrated the actuarial mortality predictions at 3.1 % versus the bariatric surgery patients' observed morality rate of 2.5 % (p = 0.01). Risk factors associated with an earlier time to death included: age, male gender, Medicare/Medicaid insurance, congestive heart failure, rheumatoid arthritis, pulmonary circulation disorders, and diabetes. No procedure-specific or perioperative complication impact for time-to-death was found.

CONCLUSION: Long-term mortality rate of patients undergoing bariatric surgery significantly improves as compared to the general population regardless of bariatric operation performed. Additionally, perioperative complications do not increase long-term mortality risk. This study did identify specific patient risk factors for long-term mortality. Special attention and consideration should be given to these "at risk" patient sub-populations.

Original languageEnglish (US)
Pages (from-to)529-536
Number of pages8
JournalSurgical Endoscopy
Volume29
Issue number3
DOIs
StatePublished - Mar 1 2015
Externally publishedYes

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Bariatric Surgery
Mortality
Population
Bariatrics
Proportional Hazards Models
Pulmonary Circulation
Social Security
Medicaid
Centers for Disease Control and Prevention (U.S.)
Medicare
Insurance
Laparoscopy
Rheumatoid Arthritis
Heart Failure

ASJC Scopus subject areas

  • Surgery

Cite this

Telem, D. A., Talamini, M., Laurie Shroyer, A., Yang, J., Altieri, M., Zhang, Q., ... Pryor, A. D. (2015). Long-term mortality rates (>8-year) improve as compared to the general and obese population following bariatric surgery. Surgical Endoscopy, 29(3), 529-536. https://doi.org/10.1007/s00464-014-3714-4

Long-term mortality rates (>8-year) improve as compared to the general and obese population following bariatric surgery. / Telem, Dana A.; Talamini, Mark; Laurie Shroyer, A.; Yang, Jie; Altieri, Maria; Zhang, Qiao; Gracia, Gerald; Pryor, Aurora D.

In: Surgical Endoscopy, Vol. 29, No. 3, 01.03.2015, p. 529-536.

Research output: Contribution to journalArticle

Telem, DA, Talamini, M, Laurie Shroyer, A, Yang, J, Altieri, M, Zhang, Q, Gracia, G & Pryor, AD 2015, 'Long-term mortality rates (>8-year) improve as compared to the general and obese population following bariatric surgery', Surgical Endoscopy, vol. 29, no. 3, pp. 529-536. https://doi.org/10.1007/s00464-014-3714-4
Telem, Dana A. ; Talamini, Mark ; Laurie Shroyer, A. ; Yang, Jie ; Altieri, Maria ; Zhang, Qiao ; Gracia, Gerald ; Pryor, Aurora D. / Long-term mortality rates (>8-year) improve as compared to the general and obese population following bariatric surgery. In: Surgical Endoscopy. 2015 ; Vol. 29, No. 3. pp. 529-536.
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T1 - Long-term mortality rates (>8-year) improve as compared to the general and obese population following bariatric surgery

AU - Telem, Dana A.

AU - Talamini, Mark

AU - Laurie Shroyer, A.

AU - Yang, Jie

AU - Altieri, Maria

AU - Zhang, Qiao

AU - Gracia, Gerald

AU - Pryor, Aurora D.

PY - 2015/3/1

Y1 - 2015/3/1

N2 - INTRODUCTION: Sparse data are available on long-term patient mortality following bariatric surgery as compared to the general population. The purpose of this study was to assess long-term mortality rates and identify risk factors for all-cause mortality following bariatric surgery.METHODS: New York State (NYS) Planning and Research Cooperative System (SPARCS) longitudinal administrative data were used to identify 7,862 adult patients who underwent a primary laparoscopic bariatric surgery from 1999 to 2005. The Social Security Death Index database identified >30-day mortalities. Risk factors for mortality were screened using a univariate Cox proportional hazard (PH) model and analyzed using a multiple PH model. Based on age, gender, and race/ethnicity, actuarial projections for NYS mortality rates obtained from Centers of Disease Control were compared to the actual post-bariatric surgery mortality rates observed.RESULTS: The mean bariatric mortality rate was 2.5 % with 8-14 years of follow-up. Mean time to death ranged from 4 to 6 year and did not differ by operation (p = 0.073). From 1999 to 2010, the actuarial mortality rate predicted for the general NYS population was 2.1 % versus the observed 1.5 % for the bariatric surgery population (p = 0.005). Extrapolating to 2013, demonstrated the actuarial mortality predictions at 3.1 % versus the bariatric surgery patients' observed morality rate of 2.5 % (p = 0.01). Risk factors associated with an earlier time to death included: age, male gender, Medicare/Medicaid insurance, congestive heart failure, rheumatoid arthritis, pulmonary circulation disorders, and diabetes. No procedure-specific or perioperative complication impact for time-to-death was found.CONCLUSION: Long-term mortality rate of patients undergoing bariatric surgery significantly improves as compared to the general population regardless of bariatric operation performed. Additionally, perioperative complications do not increase long-term mortality risk. This study did identify specific patient risk factors for long-term mortality. Special attention and consideration should be given to these "at risk" patient sub-populations.

AB - INTRODUCTION: Sparse data are available on long-term patient mortality following bariatric surgery as compared to the general population. The purpose of this study was to assess long-term mortality rates and identify risk factors for all-cause mortality following bariatric surgery.METHODS: New York State (NYS) Planning and Research Cooperative System (SPARCS) longitudinal administrative data were used to identify 7,862 adult patients who underwent a primary laparoscopic bariatric surgery from 1999 to 2005. The Social Security Death Index database identified >30-day mortalities. Risk factors for mortality were screened using a univariate Cox proportional hazard (PH) model and analyzed using a multiple PH model. Based on age, gender, and race/ethnicity, actuarial projections for NYS mortality rates obtained from Centers of Disease Control were compared to the actual post-bariatric surgery mortality rates observed.RESULTS: The mean bariatric mortality rate was 2.5 % with 8-14 years of follow-up. Mean time to death ranged from 4 to 6 year and did not differ by operation (p = 0.073). From 1999 to 2010, the actuarial mortality rate predicted for the general NYS population was 2.1 % versus the observed 1.5 % for the bariatric surgery population (p = 0.005). Extrapolating to 2013, demonstrated the actuarial mortality predictions at 3.1 % versus the bariatric surgery patients' observed morality rate of 2.5 % (p = 0.01). Risk factors associated with an earlier time to death included: age, male gender, Medicare/Medicaid insurance, congestive heart failure, rheumatoid arthritis, pulmonary circulation disorders, and diabetes. No procedure-specific or perioperative complication impact for time-to-death was found.CONCLUSION: Long-term mortality rate of patients undergoing bariatric surgery significantly improves as compared to the general population regardless of bariatric operation performed. Additionally, perioperative complications do not increase long-term mortality risk. This study did identify specific patient risk factors for long-term mortality. Special attention and consideration should be given to these "at risk" patient sub-populations.

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