title: Survival and changes in comorbidities after bariatric surgery.
abstract: OBJECTIVE
  To evaluate survival rates and changes in weight-related comorbid conditions after bariatric surgery in a high-risk patient population as compared with a similar cohort of morbidly obese patients who did not undergo surgery.
  
  
  BACKGROUND
  Morbid obesity is increasingly becoming a major public health issue. Existing studies are limited in their ability to assess the risks and benefits of bariatric surgery because few studies compare surgical patients to a similar, morbidly obese, nonsurgical cohort, especially in high-risk populations like the elderly and disabled.
  
  
  METHODS
  A retrospective cohort analysis using Medicare fee-for-service patients from 2001 to 2004. Survival rates and diagnosed presence of 5 conditions commonly comorbid with morbid obesity were examined for morbidly obese patients who did and did not undergo bariatric surgery, with up to 2 years follow-up.
  
  
  RESULTS
  Morbidly obese Medicare patients who underwent bariatric surgery had increased survival rates over the 2 years of this study when compared with a similar morbidly obese nonsurgical group (P < 0.001). For patients under the age of 65, this survival advantage started at 6 months postoperatively and for patients over age 65, at 11 months. The surgical group also experienced significant improvements in the diagnosed prevalence of 5 weight-related comorbid conditions (diabetes, sleep apnea, hypertension, hyperlipidemia, and coronary artery disease) relative to the nonsurgical cohort after 1 year postsurgery (P < 0.001).
  
  
  CONCLUSIONS
  Bariatric surgery appears to increase survival even in the high-risk, Medicare population, both for individuals aged 65 and older and those disabled and under 65. In addition, the diagnosed prevalence of weight-related comorbid conditions declined after bariatric surgery relative to a control cohort of morbidly obese patients who did not undergo surgery.
authors.affiliation: The Urban Institute, 2100 M Street NW, Washington, DC 20037, USA. cperry@ui.urban.org
authors.forename: Cynthia D
authors.initials: CD
authors.lastname: Perry
authors.forename: Matthew M
authors.initials: MM
authors.lastname: Hutter
authors.forename: Daniel B
authors.initials: DB
authors.lastname: Smith
authors.forename: Joseph P
authors.initials: JP
authors.lastname: Newhouse
authors.forename: Barbara J
authors.initials: BJ
authors.lastname: McNeil
mesh_terms: D000328:Adult; D000368:Aged; D050110:Bariatric Surgery; D016009:Chi-Square Distribution; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D006278:Medicare; D008875:Middle Aged; D009767:Obesity, Morbid / Q000453:epidemiology / Q000601:surgery*; D015995:Prevalence; D012044:Regression Analysis; D012189:Retrospective Studies; D015996:Survival Rate; D014481:United States / Q000453:epidemiology