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Previous Volume 357:753-761 August 23, 2007 Number 8 Next

	Full Text PDF PDA Full Text PowerPoint Slide Set Supplementary Material Editorial by Bray, G. A. Letters Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited E-mail When Letters Appear PubMed Citation

ABSTRACT

Background Although gastric bypass surgery accounts for 80% of bariatric surgery in the United States, only limited long-term data are available on mortality among patients who have undergone this procedure as compared with severely obese persons from a general population.

Methods In this retrospective cohort study, we determined the long-term mortality (from 1984 to 2002) among 9949 patients who had undergone gastric bypass surgery and 9628 severely obese persons who applied for driver's licenses. From these subjects, 7925 surgical patients and 7925 severely obese control subjects were matched for age, sex, and body-mass index. We determined the rates of death from any cause and from specific causes with the use of the National Death Index.

Results During a mean follow-up of 7.1 years, adjusted long-term mortality from any cause in the surgery group decreased by 40%, as compared with that in the control group (37.6 vs. 57.1 deaths per 10,000 person-years, P<0.001); cause-specific mortality in the surgery group decreased by 56% for coronary artery disease (2.6 vs. 5.9 per 10,000 person-years, P=0.006), by 92% for diabetes (0.4 vs. 3.4 per 10,000 person-years, P=0.005), and by 60% for cancer (5.5 vs. 13.3 per 10,000 person-years, P<0.001). However, rates of death not caused by disease, such as accidents and suicide, were 58% higher in the surgery group than in the control group (11.1 vs. 6.4 per 10,000 person-years, P=0.04).

Conclusions Long-term total mortality after gastric bypass surgery was significantly reduced, particularly deaths from diabetes, heart disease, and cancer. However, the rate of death from causes other than disease was higher in the surgery group than in the control group.

Source Information

From the Cardiovascular Genetics Division, University of Utah School of Medicine (T.D.A., R.E.G., S.C.H.); Intermountain Health and Fitness Institute, LDS Hospital (T.D.A.); Rocky Mountain Associated Physicians (S.C. Smith, R.C.H., S.C. Simper); and Utah Cancer Registry, University of Utah (A.M.S.) — all in Salt Lake City; School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill (W.D.R.); and the Department of Social and Preventive Medicine, University at Buffalo, Buffalo, NY (M.J.L.).

Address reprint requests to Dr. Adams at Cardiovascular Genetics, University of Utah School of Medicine, 420 Chipeta Way, Rm. 1160, Salt Lake City, UT 84108, or at ted.adams{at}utah.edu.

Full Text of this Article

Related Letters:

Bariatric Surgery and Mortality
van der Woude D., Beedupalli J., Beale M., Sjöström L., Lystig T., Carlsson L.
Extract | Full Text | PDF  
N Engl J Med 2007; 357:2633-2634, Dec 20, 2007. Correspondence

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