Predictors of long-term mortality after bariatric surgery performed in Veterans Affairs medical centers.
OBJECTIVE
The purpose of this study was to examine patient factors associated with mortality among veterans who undergo bariatric surgery.


METHODS
Prospective study that uses data from the Veterans Affairs (VA) National Surgical Quality Improvement Program.


METHODS
Group Health Center for Health Studies, the VA North Texas Health Care System, the Denver VA Medical Center, and the Durham VA Medical Center.


METHODS
We identified 856 veterans who had undergone bariatric surgery in 1 of 12 VA bariatric centers from January 1, 2000, through December 31, 2006.


METHODS
The risk of death was estimated via Cox proportional hazards.


RESULTS
The 856 veterans had a mean body mass index (BMI) of 48.7, a mean age of 54 years, and a mean DCG score of 0.76; 73.0% were men, 83.9% were white, and 7.0% had an ASA class equal to 4. Fifty-four veterans (6.3%) had died by the end of 2006. In our Cox models, patients with a BMI greater than 50 (superobesity; hazard ratio [HR], 1.8; P = .04) or a DCG score greater than or equal to 2 (HR, 3.4; P < .001) had an increased risk of death.


CONCLUSIONS
Superobese veterans and those with a greater burden of chronic disease had a greater risk of death after bariatric surgery from 2000 through 2006.
Arterburn
David
D
Group Health Center for Health Studies and Department of Medicine, Division of General Internal Medicine, University of Washington, Seattle, USA.
Livingston
Edward H
EH
Schifftner
Tracy
T
Kahwati
Leila C
LC
Henderson
William G
WG
Maciejewski
Matthew L
ML
D000368:Aged; D050110:Bariatric Surgery / Q000009:adverse effects* / Q000401:mortality*; D015992:Body Mass Index; D015331:Cohort Studies; D016208:Databases, Factual; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications / Q000401:mortality* / Q000601:surgery*; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D014481:United States; D014728:Veterans / Q000706:statistics & numerical data*