Sakran N, et al. - Researchers determined the incidence, etiologies, and risk factors for mortality following bariatric surgery (BS) using using a national BS registry. They noted a low mortality after BS. Nevertheless, mortality rates were higher in association with a variety of risk factors including male gender, advanced age, unmarried status, higher BMI, and preoperative depressive disorder. They recommended providing special attention to these “at-risk” BS patients.

Methods

• Researchers collected prospective data for all patients who underwent BS in Israel between June 2013 and June 2016, including information on age, gender, BMI, comorbidities, and surgical procedure information from the National Registry of Bariatric Surgery in Israel (NRBS).
• The 3.5-year post-BS mortality rate, obtained by cross-referencing with the Israel population registry, was assessed as the primary study outcome.

Results

• Researchers analyzed 28,755 patients (67.3% females, mean age 42.0 ± 12.5 years, and preoperative BMI 42.14 ± 5.21 kg/m²).
• Of these, 76% underwent sleeve gastrectomy (SG), 99.1% of the surgeries were performed laparoscopically, and 50.8% of the surgeries were performed in private medical centers.
• During the study period, 95 deaths occurred (146.9/100,000 person years).
• They noted that the 30-day rate of post-operative mortality was 0.04% (n = 12).
• Male gender (HR = 1.94, 95%CI 1.16–3.25), age (HR = 1.06, 95%CI 1.04–1.09), BMI (HR = 1.08, 95%CI 1.05–1.11), and depression (HR = 2.38, 95%CI 1.25–4.52) were noted to have independent association with an increased risk of all-cause 3.5-year mortality.
• However, married status (HR = 0.43, 95%CI 0.26–0.71) was observed to be associated with a decreased risk of all-cause 3.5-year mortality.