Cited by 1,392Bariatric Surgery and OutcomesBody Contouring and SurgeryCardiac, Anesthesia and Surgical Outcomes

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Perioperative Safety in the Longitudinal Assessment of Bariatric Surgery

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The Longitudinal Assessment of Bariatric Surgery (LABS) Consortium·2009·New England Journal of Medicine

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Abstract

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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Background
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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
DOI: 10.1056/nejmoa0901836
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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