Predictors of long-term mortality after bariatric surgery performed in Veterans Affairs medical centers

Group Health Center for Health Studies and Department of Medicine, Division of General Internal Medicine, University of Washington, Seattle, USA.
Archives of surgery (Chicago, Ill.: 1960) (Impact Factor: 4.93). 10/2009; 144(10):914-20. DOI: 10.1001/archsurg.2009.134
Source: PubMed


The purpose of this study was to examine patient factors associated with mortality among veterans who undergo bariatric surgery.
Prospective study that uses data from the Veterans Affairs (VA) National Surgical Quality Improvement Program.
Group Health Center for Health Studies, the VA North Texas Health Care System, the Denver VA Medical Center, and the Durham VA Medical Center.
We identified 856 veterans who had undergone bariatric surgery in 1 of 12 VA bariatric centers from January 1, 2000, through December 31, 2006.
The risk of death was estimated via Cox proportional hazards.
The 856 veterans had a mean body mass index (BMI) of 48.7, a mean age of 54 years, and a mean DCG score of 0.76; 73.0% were men, 83.9% were white, and 7.0% had an ASA class equal to 4. Fifty-four veterans (6.3%) had died by the end of 2006. In our Cox models, patients with a BMI greater than 50 (superobesity; hazard ratio [HR], 1.8; P = .04) or a DCG score greater than or equal to 2 (HR, 3.4; P < .001) had an increased risk of death.
Superobese veterans and those with a greater burden of chronic disease had a greater risk of death after bariatric surgery from 2000 through 2006.

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    • "Men generally have a higher overall risk of death than women, mostly due to violence and other gender-related factors, such as drinking, smoking, and other behaviors (31-33). Thus, the finding of no association between male gender and mortality related to surgery seems reasonable and in accordance with the findings from most long-term follow-up studies (3,8,9,22,26,34). "
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