Low death rate after obesity surgery in Sweden

Death rates soon after anti-obesity or "bariatric" surgery in Sweden are low, statistics show.

"Most published series are from high-volume expert centers," according to lead investigator Dr. Richard Marsk from Danderyd Hospital, Stockholm. "We have shown that bariatric surgery can be performed with low mortality on a national level."

Marsk and colleagues assessed deaths from any cause after weight loss surgery in Sweden using data from 14,768 bariatric procedures conducted between 1980 and 2005.

The early post-surgery death rate ranged from 0.2 percent at 30 days to 0.3 percent at 90 days, they report, with a 1-year cumulative death rate of 0.5 percent.

The 1-year cumulative death rate adjusted for age was higher for men (1.1 percent) than for women (0.4 percent) and higher for patients older than age 50 (1.2 percent) than for patients younger than age 50 (0.4 percent).

Including the entire follow-up period, the age-adjusted death rate was twice as high for men (100 per 10,000 persons per year) than for women (50 per 10,000 persons per year).

"I believe that the increased mortality seen among men is due to increased preoperative co-morbid disease and also later referral to surgery, such that men to a greater extent have established cardiovascular disease at the time of surgery," Marsk said.

"Further studies are needed to explain this in full," he added.

Cumulative mortality did not differ between patients having primary surgery or "revisional" surgery, the researchers note.

The most common causes of death during the first year after weight loss surgery were non-heart related, the investigators report, whereas the most common causes of late death were heart attack and cancer.

SOURCE: Annals of Surgery, November 2008.