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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“3% [8].”
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Background
Bariatric Surgery
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“4%, respectively) reported here are consistent with those from other large studies involving bariatric surgery in patients with BMI 35 kg/m(2).(9,14) Because these are mainly nonrandomized studies, it is likely that the surgical risk is underestimated.”
Result
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“6 % in the Longitudinal Assessment of Bariatric Surgery (LABS) consortium [6, 7].”
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“3 % for primary bariatric surgery in appropriate volume centers as reported previously in literature [15].”
Background
Decreased Escitalopram Concentrations Post–Roux-en-Y Gastric Bypass Surgery
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Obesity Surgery Working; Group, C. N. O., Stroh, C., Michel, N., Luderer, D., Wolff, S., Lange, V., KÖckerling, F., Knoll, C., & Manger, T. (2016) · Obesity Surgery · doi:10.1007/s11695-016-2182-4 · Cited by 32
Five‐year long‐term clinical outcome after bariatric metabolic surgery: A multi‐ethnic Asian population in Singapore
Toh, B. C., Chan, W. H., Eng, A. K. H., Lim, E. K. W., Lim, C. H., Tham, K. W., Fook-Chong, S. M. C., & Tan, J. T. H. (2018) · Diabetes Obesity and Metabolism · doi:10.1111/dom.13263 · Cited by 35
“3%.(13) These results confirm the safety and efficacy of bariatric surgery for durable weight loss and favourable T2DM remission within a multi-ethnic Asian population.”
Result
Validity of Privacy-Protecting Analytical Methods That Use Only Aggregate-Level Information to Conduct Multivariable-Adjusted Analysis in Distributed Data Networks
Li, X., FIREMAN, B. H., Curtis, J. R., Arterburn, D. E., Fisher, D. P., Moyneur, É., Gallagher, M., Raebel, M. A., Nowell, W. B., Lagreid, L., et al. (2018) · American Journal of Epidemiology · doi:10.1093/aje/kwy265 · Cited by 32
Prospective Assessment of Postoperative Nausea Early After Bariatric Surgery
Celio, A. C., Bayouth, L., Burruss, M. B., & Spaniolas, K. (2018) · Obesity Surgery · doi:10.1007/s11695-018-3605-1 · Cited by 32
Predicting Obstructive Sleep Apnea Among Women Candidates for Bariatric Surgery
Sharkey, K. M., Machan, J. T., Tosi, C., Roye, G. D., Harrington, D. T., & Millman, R. P. (2010) · Journal of Women s Health · doi:10.1089/jwh.2009.1859 · Cited by 32
Obesity-related cardiorenal disease: the benefits of bariatric surgery
Fenske, W., Athanasiou, T., Harling, L., Drechsler, C., Darzi, A. W., & Ashrafian, H. (2013) · Nature Reviews Nephrology · doi:10.1038/nrneph.2013.145 · Cited by 32
Clinical Management of Major Postoperative Bleeding After Bariatric Surgery
Kollmann, L., Gruber, M., Lock, J. F., Germer, C., & Seyfried, F. (2024) · Obesity Surgery · doi:10.1007/s11695-023-07040-0 · Cited by 31
Predictors of Increased Length of Hospital Stay Following Laparoscopic Sleeve Gastrectomy from the National Surgical Quality Improvement Program
Fletcher, R., Deal, R. A., Kubasiak, J., Torquati, A., & Omotosho, P. A. (2017) · Journal of Gastrointestinal Surgery · doi:10.1007/s11605-017-3642-4 · Cited by 31
Screening for Obstructive Sleep Apnea in a Diverse Bariatric Surgery Population
Kreitinger, K. Y., Lui, M. M., Owens, R. L., Schmickl, C. N., Grunvald, E. L., Horgan, S., Raphelson, J. R., & Malhotra, A. (2020) · Obesity · doi:10.1002/oby.23021 · Cited by 32
Racial disparities in complications and mortality after bariatric surgery: A systematic review
Stone, G., Samaan, J. S., & Samakar, K. (2021) · The American Journal of Surgery · doi:10.1016/j.amjsurg.2021.07.026 · Cited by 31
Standard perioperative management in gastrointestinal surgery
Grade, M., Quintel, M., & Ghadimi, Β. M. (2011) · Langenbeck s Archives of Surgery · doi:10.1007/s00423-011-0782-y · Cited by 30
A Pre-Hospital Patient Education Program Improves Outcomes of Bariatric Surgery
Brown, W. A., Burton, P. R., Shaw, K., Smith, B. M., Maffescioni, S., Comitti, B. L., Cowley, M. A., Laurie, C., Way, A., & Nottle, P. D. (2016) · Obesity Surgery · doi:10.1007/s11695-016-2075-6 · Cited by 31
“This has been the mainstay of our practice due to the safety and reversibility of the procedure [27] along with the ability to perform a”
Method
The Peri-operative Bariatric Surgery Care in the Middle East Region
Nimeri, A. A., Hadad, M. A., Khoursheed, M., Maasher, A., Qahtani, A. A., Shaban, T. A., Fawal, H., Safadi, B. Y., Alderazi, A., Abdalla, E., et al. (2016) · Obesity Surgery · doi:10.1007/s11695-016-2503-7 · Cited by 31
“In addition, OSA correlates with higher morbidity and mortality after bariatric surgery and is considered a predictor of negative outcomes [13].”
Background
Surgical Treatment of Obesity and Diabetes
Hanipah, Z. N., & Schauer, P. R. (2017) · Gastrointestinal Endoscopy Clinics of North America · doi:10.1016/j.giec.2016.12.005 · Cited by 31
Perioperative and 1-year outcomes of bariatric surgery in septuagenarians: implications for patient selection
Smith, M. E., Bacal, D., Bonham, A. J., Varban, O. A., Carlin, A. M., Ghaferi, A. A., & Finks, J. F. (2019) · Surgery for Obesity and Related Diseases · doi:10.1016/j.soard.2019.08.002 · Cited by 30
Endoscopic management in the bariatric surgical patient
Levitzky, B. E., & Wassef, W. Y. (2010) · Current Opinion in Gastroenterology · doi:10.1097/mog.0b013e32833f1239 · Cited by 30
Comparative Effectiveness of Laparoscopic Adjustable Gastric Banding vs Laparoscopic Gastric Bypass
Arterburn, D. E., Powers, J. D., Toh, S., Polsky, S., Butler, M. G., Portz, J. D., Donahoo, W. T., Herrinton, L. J., Williams, R. J., Vijayadeva, V., et al. (2014) · JAMA Surgery · doi:10.1001/jamasurg.2014.1674 · Cited by 30
Bariatric surgery: can we afford to do it or deny doing it?
Ashrafian, H., Darzi, A. W., & Athanasiou, T. (2011) · Frontline Gastroenterology · doi:10.1136/fg.2010.002618 · Cited by 30
Controversies in bariatric surgery
O’Brien, P. E. (2015) · British journal of surgery · doi:10.1002/bjs.9760 · Cited by 31
Should recent smoking be a contraindication for sleeve gastrectomy?
Haskins, I. N., Nowacki, A. S., Khorgami, Z., Schulz, K., Heinberg, L. J., Schauer, P. R., Brethauer, S. A., & Aminian, A. (2017) · Surgery for Obesity and Related Diseases · doi:10.1016/j.soard.2017.02.028 · Cited by 30
Human brown adipose tissue — function and therapeutic potential in metabolic disease
Bhatt, P. S., Dhillo, W. S., & Salem, V. (2017) · Current Opinion in Pharmacology · doi:10.1016/j.coph.2017.07.004 · Cited by 34
Physical Activity Patterns Among Individuals Before and Soon After Bariatric Surgery
Ouellette, K. A., Mabey, J. G., Eisenman, P. A., Shaw, J. M., Brusseau, T. A., Hatfield, D. L., Ford, C. N., & Davidson, L. E. (2019) · Obesity Surgery · doi:10.1007/s11695-019-04186-8 · Cited by 30
Primary care physician decision making regarding referral for bariatric surgery: a national survey
Stolberg, C. R., Hepp, N., Juhl, A. J. A., Deepti, B. C., & Juhl, C. B. (2017) · Surgery for Obesity and Related Diseases · doi:10.1016/j.soard.2017.02.002 · Cited by 30
Current Treatment of Nonalcoholic Fatty Liver Disease/Nonalcoholic Steatohepatitis
Hung, C. K., & Bodenheimer, H. C. (2017) · Clinics in Liver Disease · doi:10.1016/j.cld.2017.08.012 · Cited by 30
Feasibility and Prognostic Value of Stress Echocardiography in Obese, Morbidly Obese, and Super Obese Patients Referred for Bariatric Surgery
Supariwala, A. A., Makani, H. J., Kahan, J., Pierce, M. J., Bajwa, F. A., Dukkipati, S. S., Teixeira, J. A., & Chaudhry, F. A. (2013) · Echocardiography · doi:10.1111/echo.12481 · Cited by 29
“Males 106 (16) 19 (13) 43 (14) 44 (23) 0.”
The big fat bariatric bandwagon
Pinkney, J. H., Johnson, A. B., & Gale, E. A. M. (2010) · Diabetologia · doi:10.1007/s00125-010-1845-2 · Cited by 29
Bariatric surgery: a cure for diabetes?
Varela, J. E. (2011) · Current Opinion in Clinical Nutrition & Metabolic Care · doi:10.1097/mco.0b013e3283468e50 · Cited by 29
Is fear for postoperative cardiopulmonary complications after bariatric surgery in patients with obstructive sleep apnea justified? A systematic review
de Raaff, C. A. L., Coblijn, U. K., de Vries, N., & van Wagensveld, B. A. (2016) · The American Journal of Surgery · doi:10.1016/j.amjsurg.2015.10.026 · Cited by 29
Characterizing Readmissions After Bariatric Surgery
Garg, T., Rosas, U. S., Rogan, D. T., Hines, H., Rivas, H., Morton, J. M., & Azagury, D. E. (2016) · Journal of Gastrointestinal Surgery · doi:10.1007/s11605-016-3247-3 · Cited by 30
“3 %.(4,9,10) While bariatric surgery has increased in safety, readmissions due to complications from surgery can, and do, occur.”
Background
The Psychosocial Effects of Perioperative Complications After Bariatric Surgery
Ho, K., Hawa, R., Wnuk, S., Okrainec, A., Jackson, T. D., & Sockalingam, S. (2018) · Psychosomatics · doi:10.1016/j.psym.2018.03.005 · Cited by 29
Six-month readmissions after bariatric surgery: Results of a nationwide analysis
Rios-Diaz, A. J., Metcalfe, D., Devin, C. L., Berger, A. C., & Palazzo, F. (2019) · Surgery · doi:10.1016/j.surg.2019.06.003 · Cited by 29
Pilot Study Examining the Frequency of Several Gene Polymorphisms Involved in Morphine Pharmacodynamics and Pharmacokinetics in a Morbidly Obese Population
Lloret‐Linares, C., Hajj, A., Poitou, C., Simoneau, G., Clément, K., Laplanche, J., Lépine, J., Bergmann, J., Mouly, S. J., & Peoc’h, K. (2010) · Obesity Surgery · doi:10.1007/s11695-010-0143-x · Cited by 28
Bariatric/Metabolic Surgery: Short- and Long-Term Safety
Kim, J. H., & Wolfe, B. M. (2012) · Current Atherosclerosis Reports · doi:10.1007/s11883-012-0287-3 · Cited by 29
Hospital variation in perioperative complications for laparoscopic sleeve gastrectomy in Michigan
Pradarelli, J. C., Varban, O. A., Ghaferi, A. A., Weiner, M., Carlin, A. M., & Dimick, J. B. (2015) · Surgery · doi:10.1016/j.surg.2015.08.044 · Cited by 29
Hypoventilation Syndromes
Brown, L. K. (2010) · Clinics in Chest Medicine · doi:10.1016/j.ccm.2010.03.002 · Cited by 30
Immediate postoperative of bariatric surgery in the intensive care unit versus an inpatient unit. A retrospective study with 828 patients
Penna, G. L., Vaz, I., Fonseca, E. C., Kalichsztein, M., & Nobre, G. F. (2017) · Revista Brasileira de Terapia Intensiva · doi:10.5935/0103-507x.20170050 · Cited by 28

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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Perioperative Safety in the Longitudinal Assessment of Bariatric Surgery

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