Clinical Epidemiology and Ageing

Reduction in early mortality outcomes after bariatric surgery in France between 2007 and 2012: A nationwide study of 133,000 obese patients.

Lazzati A, Audureau E, Hemery F, Schneck A-S, Gugenheim J, Azoulay D, Iannelli A Surgery. 2016;159(2):467-74.

<p><b>BACKGROUND: </b>Early postoperative mortality after bariatric surgery has been reported in large national studies before sleeve gastrectomy (SG) was introduced as a stand-alone procedure. The aim of this study was to investigate the 90-day postoperative mortality rates after bariatric surgery in France on a nationwide basis.</p><p><b>METHODS: </b>All morbidly obese patients who underwent adjustable gastric banding (AGB), gastric bypass (GBP), or SG in France between 2007 and 2012 were included in this study. Multivariate analyses were conducted using the French National Health Service Database data to ascertain predictive factors for 90-day postoperative mortality.</p><p><b>RESULTS: </b>Data from 133,804 patients were analyzed. SG was performed in 36.5% of cases, GBP in 31.2%, AGB in 32.3%, and revisional surgery in 5.1%. The postoperative mortality rate (POM) for the 3 procedures was 0.12%. The rate of POM remained stable for AGB (0.01%), and it decreased from 0.25 to 0.08% and from 0.36 to 0.11% for SG and GBP, respectively. POM was greater among male patients and was associated with age, type-2 diabetes, high blood pressure, body mass index, open surgery, and hospital procedural volume.</p><p><b>CONCLUSION: </b>The rate of early mortality after bariatric surgery was low, and has decreased greatly during the past few years. AGB presents a mortality rate close to nil and SG has a risk of early mortality that is about half that of GBP.</p>

MeSH terms: Adult; Bariatric Surgery; Databases, Factual; Female; Follow-Up Studies; France; Humans; Logistic Models; Male; Middle Aged; Multivariate Analysis; Obesity, Morbid; Retrospective Studies; Risk Factors
DOI: 10.1016/j.surg.2015.08.005