Long-term all-cause and cause-specific mortality for four bariatric surgery procedures

Area of Science:

• Medical research
• Surgical outcomes
• Public health

Background:

• Bariatric surgery is a common intervention for severe obesity.
• Long-term mortality data following bariatric surgery are crucial for understanding its overall impact.
• Previous studies have shown benefits, but long-term durability and specific risks require further investigation.

Purpose of the Study:

• To evaluate the long-term mortality outcomes associated with various bariatric surgery procedures.
• To compare mortality rates between individuals who underwent bariatric surgery and matched controls.
• To analyze mortality trends across different age groups at the time of surgery.

Main Methods:

• A retrospective study design was employed.
• Matched pairs (1:1) of bariatric surgery patients and non-surgery controls were created based on age, sex, BMI, and surgery date.
• Mortality rates were compared using Cox regression analysis, stratified by sex, surgery type, and age at surgery.

Main Results:

• The study included 21,837 matched pairs with up to 40 years of follow-up.
• All-cause mortality was 16% lower in the bariatric surgery group compared to the non-surgery group.
• Significant reductions in mortality were observed for cardiovascular disease (29%), cancer (43%), and diabetes (72%).
• The hazard ratio for suicide was 2.4 times higher in the surgery group, particularly in those aged 18-34 years at surgery.

Conclusions:

• Reduced all-cause mortality following bariatric surgery is durable over decades and applies to various procedures, sexes, and individuals over 34 years old at surgery.
• While bariatric surgery offers significant long-term survival benefits, an increased risk of suicide death is noted specifically in the youngest age group (18-34 years) undergoing surgery.