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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Article info
Publication history
Published online: October 21, 2019
Accepted:
October 11,
2019
Received:
July 31,
2019
Footnotes
This study was financially supported by The Erling-Persson Family Foundation (AT).
Identification
Copyright
© 2019 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.
