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Predictors of long-term mortality after bariatric surgery performed in Veterans Affairs medical centers
Arterburn, D., Livingston, E. H., Schifftner, T., Kahwati, L. C., Henderson, W. G., & Maciejewski, M. L. (2009). Predictors of long-term mortality after bariatric surgery performed in Veterans Affairs medical centers. JAMA Surgery, 144(10), 914-920. https://doi.org/10.1001/archsurg.2009.134
HYPOTHESIS: The purpose of this study was to examine patient factors associated with mortality among veterans who undergo bariatric surgery.
DESIGN: Prospective study that uses data from the Veterans Affairs (VA) National Surgical Quality Improvement Program.
SETTING: Group Health Center for Health Studies, the VA North Texas Health Care System, the Denver VA Medical Center, and the Durham VA Medical Center.
PATIENTS: We identified 856 veterans who had undergone bariatric surgery in 1 of 12 VA bariatric centers from January 1, 2000, through December 31, 2006.
MAIN OUTCOME MEASURES: The risk of death was estimated via Cox proportional hazards.
RESULTS: 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.
CONCLUSION: Superobese veterans and those with a greater burden of chronic disease had a greater risk of death after bariatric surgery from 2000 through 2006.
