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Cited by 685Bariatric Surgery and OutcomesBody Contouring and SurgeryMinimally Invasive Surgical Techniques

Trends in mortality in bariatric surgery: a systematic review and meta-analysis

Buchwald, Henry, Estok, Rhonda, Fahrbach, Kyle, Banel, Deirdre, Sledge, Isabella·2007·Surgery
DOI 10.1016/j.surg.2007.07.018
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Abstract

Background This is the first systematic review and meta-analysis of published mortality data after bariatric surgery.Methods The review includes all papers published in English from January 1, 1990 to April 30, 2006, identified through electronic searches in MEDLINE, Current Contents, and the Cochrane Library, supplemented by manual reference checks. All accepted studies were assigned a level of evidence (Centre for Evidence-Based Medicine, Oxford, UK), and randomized controlled trials were rated for quality using the Jadad scoring method. Random effects meta-analyses were performed. Mortality was analyzed at either <or=30 days or 30 days to 2 years.Results The data set includes 361 studies with 478 treatment arms and 85,048 patients. At baseline, the mean age was 40.0 years, body mass index was 47.4 kg/m2, 85% were female, and 11.5% had previous bariatric procedures. Meta-analysis of total mortality at <or=30 days was 0.28% (95% confidence interval [CI], 0.22-0.34) in 475 treatment arms (n = 84,931); total mortality at >30 days to 2 years was 0.35% (95% CI, 0.12-0.58) in 140 treatment arms (n = 19,928). Mortality at <or=30 day for all restrictive procedures was 0.30% (95% CI, 0.15-0.46) for open and 0.07% (95% CI, 0.02-0.12) for laparoscopic procedures; restrictive/malabsorptive (gastric bypass) was 0.41% (95% CI, 0.24-0.58] for open and 0.16% (95% CI, 0.09-0.23) for laparoscopic; and malabsorptive was 0.76% (95% CI, 0.29-1.23) for open and 1.11% (95% CI, 0.00-2.70) for laparoscopic. Subgroup analyses of <or=30-day mortality show a male:female ratio of 4.74:0.13, with 1.25% (95% CI, 0.56-1.94) incidence in the superobese and 0.34% (95% CI, 0.00-1.29) in the elderly (>or=65 years).Conclusion The early and late mortality rates after bariatric surgery are low and can be subjected to risk stratification for comparative analyses and prospective risk assessments.

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Crossref · 10.1016/j.surg.2007.07.018

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  • The operative mortality rate after bariatric surgery is low relative to other major surgical procedures and ranges from 0.28% to 0.4%.

    “Relative to other major surgical procedures, the operative mortality rate after bariatric surgery is low and it ranges from 0.28% to 0.4% [110-113].”

    From Bariatric surgery: remission of inflammation, cardiometabolic benefits, and common adverse effects (2020) · cites this paper as [110]

  • Rates of morbidity and mortality directly related to bariatric surgery have been reduced considerably in recent years, with 30-day mortality rates now 0.28%, similar to those of laparoscopic cholecystectomy.

    “Rates of morbidity and mortality directly related to the surgery have been reduced considerably in recent years, with 30-day mortality rates now 0.28%, similar to those of laparoscopic cholecystectomy (98).”

    From Standards of Medical Care in Diabetes—2009 (2009) · cites this paper as [98]

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Authors
Buchwald, H., Estok, R., Fahrbach, K., Banel, D., & Sledge, I.
ORCID
Fahrbach, Kyle
Venue
Surgery
Publisher
Elsevier BV
Published
2007-10
Volume
142
Issue
4
Pages
621-635
ISSN
0039-6060 (ISSN-L)
DOI
10.1016/j.surg.2007.07.018
OpenAlex
W1997594107
Cited by
685
References
22
Citations by year
2026: 6 · 2025: 6 · 2024: 17 · 2023: 25 · 2022: 20 · 2021: 18 · 2020: 18 · 2019: 39 · 2018: 34 · 2017: 29 · 2016: 42 · 2015: 50 · 2014: 56 · 2013: 64 · 2012: 66
FWCI
6.93
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Surgery (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
  • Health Sciences › Medicine › Surgery › Body Contouring and Surgery
  • Health Sciences › Medicine › Surgery › Minimally Invasive Surgical Techniques
Keywords
bariatric surgery, postoperative mortality, restrictive practices, malabsorptive surgery, laparoscopic surgery, open surgery, gastric bypass, morbid obesity, 30-day mortality, long-term mortality, sex differences, body mass index, mortality trends, quality of evidence, subgroup analysis, meta-regression, publication bias
MeSH terms
Humans, Obesity, Morbid, Comorbidity, Risk Assessment, Bariatric Surgery

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