title: Thirty-day mortality after bariatric surgery: independently adjudicated causes of death in the longitudinal assessment of bariatric surgery.
abstract: BACKGROUND
  Mortality following bariatric surgery is a rare event in contemporary series, making it difficult for any single center to draw meaningful conclusions as to cause of death. Nevertheless, much of the published mortality data come from single-center case series and reviews of administrative databases. These sources tend to produce lower mortality estimates than those obtained from controlled clinical trials. Furthermore, information about the causes of death and how they were determined is not always available. The aim of the present report is to describe in detail all deaths occurring within 30 days of surgery in the Longitudinal Assessment of Bariatric Surgery (LABS).
  
  
  METHODS
  LABS is a ten-center observational cohort study of bariatric surgical outcomes. Data were collected prospectively for bariatric surgeries performed between March 2005 and April 2009. All deaths occurring within 30-days of surgery were identified, and cause of death assigned by an independent Adjudication Subcommittee, blinded to operating surgeon and site.
  
  
  RESULTS
  Six thousand one hundred eighteen patients underwent primary bariatric surgery. Eighteen deaths (0.3%) occurred within 30-days of surgery. The most common cause of death was sepsis (33% of deaths), followed by cardiac causes (28%), and pulmonary embolism (17%). For one patient cause of death could not be determined despite examination of all available information.
  
  
  CONCLUSIONS
  This study confirms the low 30-day mortality rate following bariatric surgery. The recognized complications of anastomotic leak, cardiac events, and pulmonary emboli accounted for the majority of 30-day deaths.
authors.affiliation: Legacy Good Samaritan Hospital, Portland, OR 97210, USA. mdsmith2@mac.com
authors.forename: Mark D
authors.initials: MD
authors.lastname: Smith
authors.forename: Emma
authors.initials: E
authors.lastname: Patterson
authors.forename: Abdus S
authors.initials: AS
authors.lastname: Wahed
authors.forename: Steven H
authors.initials: SH
authors.lastname: Belle
authors.forename: Paul D
authors.initials: PD
authors.lastname: Berk
authors.forename: Anita P
authors.initials: AP
authors.lastname: Courcoulas
authors.forename: Gregory F
authors.initials: GF
authors.lastname: Dakin
authors.forename: David R
authors.initials: DR
authors.lastname: Flum
authors.forename: Laura
authors.initials: L
authors.lastname: Machado
authors.forename: James E
authors.initials: JE
authors.lastname: Mitchell
authors.forename: John
authors.initials: J
authors.lastname: Pender
authors.forename: Alfons
authors.initials: A
authors.lastname: Pomp
authors.forename: Walter
authors.initials: W
authors.lastname: Pories
authors.forename: Ramesh
authors.initials: R
authors.lastname: Ramanathan
authors.forename: Beth
authors.initials: B
authors.lastname: Schrope
authors.forename: Myrlene
authors.initials: M
authors.lastname: Staten
authors.forename: Akuezunkpa
authors.initials: A
authors.lastname: Ude
authors.forename: Bruce M
authors.initials: BM
authors.lastname: Wolfe
mesh_terms: D000328:Adult; D050110:Bariatric Surgery / Q000401:mortality*; D002423:Cause of Death; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013997:Time Factors