Bariatric surgery is associated with a reduced risk of mortality in morbidly obese patients with a history of major cardiovascular events.
Although the safety of bariatric surgery in patients with established cardiovascular disease has been demonstrated, little is known about the mid- to long-term survival of these patients after surgery. We conducted a retrospective cohort study of bariatric surgical patients (n = 349)  compared with morbidly obese surgical controls (n = 903). Data were obtained on all patients 40 to 79 years of age, from 1996 to 2008, with a diagnosis code of morbid obesity, a primary surgical procedure of interest, and a cardiovascular event history. Data sources were the statewide South  Carolina UB92 inpatient hospitalization database and death records. The primary outcome was all-cause mortality. A total of 349 bariatric and 903 control patients with cardiovascular event histories were identified. Among bariatric patients, 19 deaths occurred in 986 person-years of follow-up  versus 150 deaths among controls in 3138 person-years of follow-up. Unadjusted all-cause mortality was estimated at 7 ± 2 per cent at 5 years in bariatric patients compared with 19 ± 2 per cent (P < 0.001) in controls. Adjusting for age, comorbidities, and event  history, the relative risk of mortality was reduced by 40 per cent in bariatric patients compared with controls [hazard ratios (95% confidence interval): 0.60 (0.36, 0.99)]. In patients with a history of cardiovascular events, bariatric surgery is associated with a significantly decreased  risk of all-cause mortality.
Greenville Hospital System University Medical Center, Greenville, South Carolina, USA.
Rebecca J
RJ
Johnson
Brent L
BL
Johnson
Dawn W
DW
Blackhurst
Eric S
ES
Bour
William S
WS
Cobb
Alfredo M
AM
Carbonell
Jonathan S
JS
Lokey
John D
JD
Scott
D000328:Adult; D000368:Aged; D050110:Bariatric Surgery; D002318:Cardiovascular Diseases / Q000150:complications / Q000453:epidemiology*; D002423:Cause of Death / Q000639:trends; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009017:Morbidity / Q000639:trends; D009767:Obesity, Morbid / Q000150:complications / Q000601:surgery*; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D013022:South Carolina / Q000453:epidemiology; D015431:Weight Loss