Rookes Nathaniel, Al-Asadi Oday, Yeluri Sashi, Vasas Peter, Samuel Nehemiah, Balchandra Srinivasan, Hussain Abdulzahra
Medical School, University of Sheffield, Sheffield, UK.
Homerton University Hospital, London, UK.
Obes Surg. 2025 Jan;35(1):47-58. doi: 10.1007/s11695-024-07466-0. Epub 2024 Aug 31.
There is a lack of up-to-date research addressing the causes of death and predictors of long-term mortality after bariatric surgery.
This was a single-centre retrospective study. Trust records were used to identify deceased patients and their medical history. The demographic data, comorbidities, cause of death, and time since surgery were retrieved and tabulated. Data was recoded to allow for use in IBM SPSS.
There were 39 deaths amongst 891 patients who underwent bariatric surgery between 15th June 2010 to 18th September 2022. The main cause of death was pneumonia and respiratory causes with 15.4% of the cohort. A history of asthma/COPD had an association with the cause of death (p = 0.021). A history of hypertension, ischaemic heart disease (IHD), and smoking were all associated with a higher age at death, whilst a history of IHD was associated with a higher number of days from operation to death. Age at operation and number of comorbidities both correlated with age at death, and multiple linear regression of age at death with age at operation and number of comorbidities as predictors was significant (p < 0.001). A Cox regression found age at operation to have a significant effect on survival, with a hazard ratio of 1.063 (95% CI:1.027 to 1.100, p < 0.001).
Pneumonia and respiratory causes are the largest causes of long-term mortality after bariatric surgery. The only factor found to have a detrimental effect on all-cause mortality was age at operation which reduced survival. Hypertension, IHD, and smoking are indirect factors that are associated with mortality.
目前缺乏关于减肥手术后死亡原因及长期死亡率预测因素的最新研究。
这是一项单中心回顾性研究。利用信托记录来识别已故患者及其病史。检索并整理人口统计学数据、合并症、死亡原因及手术后时间。对数据进行重新编码以便在IBM SPSS中使用。
在2010年6月15日至2022年9月18日期间接受减肥手术的891名患者中，有39人死亡。主要死亡原因是肺炎和呼吸道疾病，占队列的15.4%。哮喘/慢性阻塞性肺疾病病史与死亡原因有关（p = 0.021）。高血压、缺血性心脏病（IHD）和吸烟史均与较高的死亡年龄有关，而IHD病史与从手术到死亡的天数较多有关。手术时年龄和合并症数量均与死亡年龄相关，以手术时年龄和合并症数量作为预测因素对死亡年龄进行多元线性回归具有显著性（p < 0.001）。Cox回归发现手术时年龄对生存率有显著影响，风险比为1.063（95%置信区间：1.027至1.100，p < 0.001）。
肺炎和呼吸道疾病是减肥手术后长期死亡的主要原因。发现对全因死亡率有不利影响的唯一因素是手术时年龄，它会降低生存率。高血压、IHD和吸烟是与死亡率相关的间接因素。
