Perioperative safety in the longitudinal assessment of bariatric surgery
Open accessAbstract
BACKGROUND: To improve decision making in the treatment of extreme obesity, the risks of bariatric surgical procedures require further characterization. METHODS: We performed a prospective, multicenter, observational study of 30-day outcomes in consecutive patients undergoing bariatric surgical procedures at 10 clinical sites in the United States from 2005 through 2007. A composite end point of 30-day major adverse outcomes (including death; venous thromboembolism; percutaneous, endoscopic, or operative reintervention; and failure to be discharged from the hospital) was evaluated among patients undergoing first-time bariatric surgery. RESULTS: There were 4776 patients who had a first-time bariatric procedure (mean age, 44.5 years; 21.1% men; 10.9% nonwhite; median body-mass index [the weight in kilograms divided by the square of the height in meters], 46.5). More than half had at least two coexisting conditions. A Roux-en-Y gastric bypass was performed in 3412 patients (with 87.2% of the procedures performed laparoscopically), and laparoscopic adjustable gastric banding was performed in 1198 patients; 166 patients underwent other procedures and were not included in the analysis. The 30-day rate of death among patients who underwent a Roux-en-Y gastric bypass or laparoscopic adjustable gastric banding was 0.3%; a total of 4.3% of patients had at least one major adverse outcome. A history of deep-vein thrombosis or pulmonary embolus, a diagnosis of obstructive sleep apnea, and impaired functional status were each independently associated with an increased risk of the composite end point. Extreme values of body-mass index were significantly associated with an increased risk of the composite end point, whereas age, sex, race, ethnic group, and other coexisting conditions were not. CONCLUSIONS: The overall risk of death and other adverse outcomes after bariatric surgery was low and varied considerably according to patient characteristics. In helping patients make appropriate choices, short-term safety should be considered in conjunction with both the long-term effects of bariatric surgery and the risks associated with being extremely obese. (ClinicalTrials.gov number, NCT00433810.)
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The complication evidence base included those studies from the efficacy and predictors searches that included complication data, as well as those studies that met the expanded search criteria.
“The complication evidence base included those studies from the efficacy and predictors searches that included complication data,141,156 as well as those studies that met the expanded search criteria.139,143,145,146,152,153,160,170,171”
From 2013 AHA/ACC/TOS Guideline for the Management of Overweight and Obesity in Adults (2014) · cites this paper as [153]
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 [111]
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- Authors
- The Longitudinal Assessment of Bariatric Surgery (LABS) Consortium
- Affiliations
- University of Washington (US)
- Corresponding author
- The Longitudinal Assessment of Bariatric Surgery (LABS) Consortium
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 2009-07-30
- Volume
- 361
- Issue
- 5
- Pages
- 445-454
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- PMC
- PMC2854565
- OpenAlex
- W1558000543
- Cited by
- 1,392
- References
- 21
- Citations by year
- 2026: 17 · 2025: 30 · 2024: 34 · 2023: 44 · 2022: 64 · 2021: 52 · 2020: 73 · 2019: 82 · 2018: 79 · 2017: 88 · 2016: 115 · 2015: 122 · 2014: 136 · 2013: 107 · 2012: 121
- FWCI
- 116.28
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- New England Journal of Medicine (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (UL1TR000005)
- National Institute of Diabetes and Digestive and Kidney Diseases (U01DK066471, U01DK066557, U01DK066526, U01DK066568, U01DK066555, U01DK066667, U01DK066585)
- National Center for Research Resources (M01RR000037)
- National Center for Advancing Translational Sciences
- Topics
- Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
- Health Sciences › Medicine › Surgery › Body Contouring and Surgery
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac, Anesthesia and Surgical Outcomes
- Keywords
- bariatric surgery, perioperative safety, morbid obesity, Roux-en-Y gastric bypass, laparoscopic adjustable gastric banding, postoperative mortality, venous thromboembolism, obstructive sleep apnea, body mass index, risk factors, patient decision-making
- MeSH terms
- Adult, Aged, Female, Humans, Length of Stay, Male, Middle Aged, Obesity, Postoperative Complications, Prospective Studies, Reoperation, Risk Factors, Thromboembolism, Comorbidity, Body Mass Index, Outcome Assessment, Health Care, Observation, Sleep Apnea, Obstructive, Venous Thrombosis, Bariatric Surgery
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