Department of Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania; Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania.
Department of Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.
Surg Obes Relat Dis. 2019 Oct;15(10):1755-1765. doi: 10.1016/j.soard.2019.08.015. Epub 2019 Aug 26.
Patients having bariatric surgery have lower mortality compared with those with similar body mass index who do not undergo surgery. It is unclear whether mortality post-bariatric surgery is similar to the general population. The benefit of bariatric surgery would be highlighted should people previously at high risk for premature death have comparable, or better, mortality as the general population.
To compare mortality after bariatric surgery to the general U.S. population of the same age, sex, and race.
The Longitudinal Assessment of Bariatric Surgery-2 (LABS-2) prospective cohort of 2458 adults who underwent bariatric surgery at 10 U.S. hospitals between 2006 and 2009.
Deaths were identified via LABS-2 follow-up and the National Death Index. Standardized mortality ratios (SMR) of post-bariatric surgery mortality observed in LABS-2 versus age-, sex-, race-, and year-adjusted expected mortality in the general U.S. population were calculated and compared with 1, which results when the number of observed and expected deaths are equal.
LABS-2 median follow-up was 6.6 (interquartile range: 5.9-7.0) years postsurgery. Seventy-six deaths were observed over 15,616 person-years (PY) of observation (4.9 deaths/1000 PY). The rate expected in the general U.S. population with the same age, sex, race, and year distribution was 4.8 deaths per 1000 PY (SMR = 1.02, 95% confidence interval [CI]: .80-1.27). There were no significant differences between observed and expected mortality by surgical procedure. Compared with expected mortality in the general U.S. population, people 35-44 years old at time of surgery had significantly more deaths (SMR = 2.06, 95% CI: 1.22-3.25), while people at least 55 years of age had significantly fewer (SMR = .63, 95% CI: .42-.92). Significantly more deaths than expected occurred in the perioperative period and 5-7 years after surgery.
Mortality within 7 years of bariatric surgery is comparable to the general U.S. population, which is likely to have better survival than people with severe obesity. However, more deaths than expected were identified 5-7 years after surgery.
接受减重手术的患者死亡率低于未接受手术的体重指数相似的患者。尚不清楚减重手术后的死亡率是否与普通人群相似。如果以前有过早死亡高风险的人死亡率与普通人群相当或更好，那么减重手术的益处将更加显著。
比较减重手术后的死亡率与普通美国人口的死亡率，这些人年龄、性别和种族相同。
2006 年至 2009 年在美国 10 家医院接受减重手术的 2458 名成年人的纵向评估减重手术-2（LABS-2）前瞻性队列。
通过 LABS-2 随访和国家死亡指数确定死亡。计算 LABS-2 中观察到的减重手术后死亡率与普通美国人群中年龄、性别、种族和年份调整后的预期死亡率的标准化死亡率比（SMR），并与 1 进行比较，当观察到的和预期的死亡人数相等时，结果为 1。
LABS-2 中位数随访时间为手术后 6.6 年（四分位距：5.9-7.0）。在观察到的 15616 人年（PY）中观察到 76 例死亡（4.9 例/1000 PY）。在具有相同年龄、性别、种族和年份分布的普通美国人群中预期的死亡率为每 1000 PY 4.8 例死亡（SMR=1.02，95%置信区间[CI]：0.80-1.27）。手术程序之间观察到的死亡率与预期死亡率无显著差异。与普通美国人群的预期死亡率相比，手术时年龄在 35-44 岁的人死亡人数明显更多（SMR=2.06，95%CI：1.22-3.25），而至少 55 岁的人死亡人数明显更少（SMR=0.63，95%CI：0.42-0.92）。术后 5-7 年期间，围手术期和术后的死亡人数明显多于预期。
在接受减重手术后的 7 年内，死亡率与普通美国人群相当，这可能意味着他们的生存率高于严重肥胖人群。然而，在手术后 5-7 年内发现的死亡人数超过预期。
