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Low overall mortality during 10 years of bariatric surgery: nationwide study on 63,469 procedures from the Scandinavian Obesity Registry

Published:October 21, 2019DOI:https://doi.org/10.1016/j.soard.2019.10.012

      Highlights

      • The early (30- and 90-day) and one-year mortality rates were low
      • Depression, leakage and thromboembolic events increased early mortality risks
      • In addition, age and abdominal circumference predicted mortality at one year
      • The low mortality rates demonstrate that bariatric surgery in Sweden is safe

      Abstract

      Background

      Bariatric surgery results in an improvement in quality of life, co-morbid diseases, and an increased life expectancy. However, to obtain these benefits perioperative mortality rates need to be low.

      Objectives

      Evaluate 90-day and 1-year mortality after bariatric surgery in Sweden from 2008 to 2017.

      Setting

      National quality register.

      Methods

      Data on applicable patients from the Scandinavian Obesity Surgery Registry, including 63,469 patients (85.1% gastric bypass, 12.5% sleeve gastrectomy, .8% duodenal switch, .5% minor revisions, and 1.1% other procedures), were retrieved and matched to the Cause of Death registry.

      Results

      During the 10-year period, 36 patients died within 90 days, resulting in a .06% overall mortality. The 1-year mortality rate was .19% (n = 111). Both mortality rates decreased over the study period. In a multivariate analysis, depression (odds ratio [OR] 2.38, [95% confidence interval 1.48–3.84]), leakage (OR 9.32 [4.85–17.94]), and thromboembolic events (OR 7.60 [1.63–35.37]) increased mortality risks at both 90 days and 1 year, whereas age (OR 1.03 [1.01–1.06] per increased year of age) and abdominal circumference (OR 1.03 [1.01–1.05] per cm) were also associated with increased mortality at 1 year. The predictive value of the Obesity Surgery Mortality Risk Score was confirmed.

      Conclusions

      The low 90-day and 1-year mortality, .06% and .19%, respectively, demonstrates that bariatric surgery in Sweden is safe. The use of antidepressants and 2 serious postoperative complications were the most significant risk factors for early deaths, while increased age and preoperative abdominal circumference also contributed at 1 year.

      Key words

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