Low overall mortality during 10 years of bariatric surgery: nationwide study on 63,469 procedures from the Scandinavian Obesity Registry |
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Affiliation: | 1. Department of Surgical Sciences, Uppsala University, Uppsala, Sweden;2. Department of Clinical Sciences, Danderyd Hospital, Stockholm, Sweden;3. Department of Medical Sciences, Örebro University, Örebro, Sweden;1. Defiance County Health Department, Defiance, Ohio;2. Division of Pediatric Surgery, Children’s Hospital of Colorado and University of Colorado, Anschutz Medical Campus, Aurora, Colorado;3. Division of Pediatric Surgery, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio;1. Digestive Disease Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates;2. Department of General Surgery, Cleveland Clinic, Cleveland, Ohio;3. Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, Ohio;1. Department of Public Health Sciences, 525 Edwards Hall, Clemson University, Clemson, South Carolina;2. Greenville Health System, Greenville, South Carolina |
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Abstract: | BackgroundBariatric surgery results in an improvement in quality of life, co-morbid diseases, and an increased life expectancy. However, to obtain these benefits perioperative mortality rates need to be low.ObjectivesEvaluate 90-day and 1-year mortality after bariatric surgery in Sweden from 2008 to 2017.SettingNational quality register.MethodsData on applicable patients from the Scandinavian Obesity Surgery Registry, including 63,469 patients (85.1% gastric bypass, 12.5% sleeve gastrectomy, .8% duodenal switch, .5% minor revisions, and 1.1% other procedures), were retrieved and matched to the Cause of Death registry.ResultsDuring the 10-year period, 36 patients died within 90 days, resulting in a .06% overall mortality. The 1-year mortality rate was .19% (n = 111). Both mortality rates decreased over the study period. In a multivariate analysis, depression (odds ratio [OR] 2.38, [95% confidence interval 1.48–3.84]), leakage (OR 9.32 [4.85–17.94]), and thromboembolic events (OR 7.60 [1.63–35.37]) increased mortality risks at both 90 days and 1 year, whereas age (OR 1.03 [1.01–1.06] per increased year of age) and abdominal circumference (OR 1.03 [1.01–1.05] per cm) were also associated with increased mortality at 1 year. The predictive value of the Obesity Surgery Mortality Risk Score was confirmed.ConclusionsThe low 90-day and 1-year mortality, .06% and .19%, respectively, demonstrates that bariatric surgery in Sweden is safe. The use of antidepressants and 2 serious postoperative complications were the most significant risk factors for early deaths, while increased age and preoperative abdominal circumference also contributed at 1 year. |
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Keywords: | Bariatric surgery Mortality Complications Gastric bypass Sleeve gastrectomy |
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