Perioperative Safety in the Longitudinal Assessment of Bariatric Surgery

• Published in: The New England journal of medicine Vol. 361; no. 5; pp. 445 - 454
• Main Authors: Flum, David Reed, Belle, Steven H, King, Wendy C, Wahed, Abdus S, Berk, Paul, Chapman, William, Pories, Walter, Courcoulas, Anita, McCloskey, Carol, Mitchell, James, Patterson, Emma, Pomp, Alfons, Staten, Myrlene A, Yanovski, Susan Z, Thirlby, Richard, Wolfe, Bruce
• Format: Journal Article
• Language: English
• Published: Waltham, MA Massachusetts Medical Society 30-07-2009
• Subjects: Adult; Aged; Bariatric Surgery - methods; Bariatric Surgery - mortality; Biological and medical sciences; Body Mass Index; Comorbidity; Female; Gastrointestinal surgery; General aspects; Humans; Length of Stay; Male; Medical sciences; Middle Aged; Obesity; Obesity - complications; Obesity - surgery; Observation; Outcome Assessment (Health Care); Patient care planning; Patient safety; Postoperative Complications - epidemiology; Postoperative Complications - mortality; Prospective Studies; Reoperation - statistics & numerical data; Risk assessment; Risk Factors; Sleep Apnea, Obstructive - complications; Thromboembolism - epidemiology; Venous Thrombosis - epidemiology; Medicine; Perioperative; Safety; Toxicity; Bariatric surgery
• ISSN: 0028-4793; 1533-4406
• DOI: 10.1056/NEJMoa0901836

This prospective, multicenter, observational study shows 30-day outcomes for a composite end point (death, venous thromboembolism, reintervention, or failure to be discharged from the hospital within 30 days after surgery) among consecutive patients undergoing bariatric surgery. The overall risks of death and adverse outcomes were low but were increased among patients who had the highest body-mass index and certain coexisting conditions. The short-term safety of bariatric surgery should be considered in conjunction with both the long-term effects and the risk of living with extreme obesity.
This study shows 30-day outcomes among patients undergoing bariatric surgery. The overall risks of death and adverse outcomes were low but were increased among patients who had the highest body-mass index and certain coexisting conditions.
The benefits of bariatric surgery are increasingly reported. A recent, small, randomized trial
1
showed that there was a remission of diabetes in a majority of patients who underwent bariatric surgery, and the favorable effect of bariatric surgery on cardiovascular disease was shown in a large, matched cohort of patients who either underwent surgery or received usual care.
2
Recent studies
3
,
4
showed that the risk of death over time was approximately 35% lower among extremely obese patients who underwent bariatric surgery than among those who did not. Nevertheless, concern about the safety of bariatric surgery has grown with its increasing popularity . . .