title: Gastric bypass improves survival compared with propensity-matched controls: a cohort study with over 10-year follow-up.
abstract: BACKGROUND
  The purpose of this study is to evaluate the long-term survival following gastric bypass using propensity-matched controls.
  
  
  METHODS
  We identified all patients who either received a gastric bypass (GBP) or met criteria to receive a GBP between January 1, 2002 and December 31, 2003. Propensity matching was performed. Long-term, all-cause mortality data were collected and evaluated using Kaplan-Meier curves.
  
  
  RESULTS
  Four hundred thirty GBP cases and 5,323 controls were identified from the enrollment period. Ultimately, 802 cases and controls (1:1 matching, 93.2% match rate) were identified using propensity matching. Median follow-up was similar between groups. Overall mortality was lower for the GBP group (odds ratio .48, 95% confidence interval .29 to .78). GBP demonstrated significantly increased survival when compared with controls (P = .002). Similar patterns were noted among diabetics.
  
  
  CONCLUSIONS
  We have demonstrated that gastric bypass provides a clear long-term survival advantage compared with nonsurgical propensity-matched controls.
authors.affiliation: Department of Surgery, The University of Virginia Health System, Charlottesville, VA, USA. Electronic address: cag3db@virginia.edu.
authors.forename: Christopher A
authors.initials: CA
authors.lastname: Guidry
authors.affiliation: Department of Surgery, The University of Virginia Health System, Charlottesville, VA, USA.
authors.forename: Stephen W
authors.initials: SW
authors.lastname: Davies
authors.affiliation: Department of Surgery, The University of Virginia Health System, Charlottesville, VA, USA.
authors.forename: Robert G
authors.initials: RG
authors.lastname: Sawyer
authors.affiliation: Department of Surgery, The University of Virginia Health System, Charlottesville, VA, USA.
authors.forename: Bruce D
authors.initials: BD
authors.lastname: Schirmer
authors.affiliation: Department of Surgery, The University of Virginia Health System, Charlottesville, VA, USA.
authors.forename: Peter T
authors.initials: PT
authors.lastname: Hallowell
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D005544:Forecasting; D015390:Gastric Bypass / Q000379:methods*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000401:mortality / Q000601:surgery*; D057216:Propensity Score; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology
keywords: Gastric bypass; Obesity; Propensity; Survival