11 Feb Gastric Bypass Surgery Reduces Mortality Even In Older Patients
MedicalResearch.com Interview with:
Lance Davidson, PhD
Department of Exercise Sciences
Brigham Young University
Provo, UT 84602
Medical Research: What is the background for this study? What are the main findings?
Dr. Davidson: A growing body of literature indicates that bariatric surgery imparts a mortality benefit in severely obese individuals. Whether age at surgery affects this relationship is not well established. One might suppose that a person who has been severely obese for several decades may already have sustained enough metabolic damage that weight loss surgery would have less influence on subsequent mortality. We conducted an age-specific analysis of a previously-published mortality cohort in gastric bypass patients and severely obese controls, following them for up to 18 years (mean 7.2 years), and examined mortality rates in four age categories: under 35, 35-44, 45-54, and 55-74.
The primary finding of this retrospective cohort study was that gastric bypass surgery attenuated the age-related increase in mortality, demonstrating a widening gap in mortality risk when compared to age-matched severely obese controls as age-at-surgery increased, with a 66% reduction in mortality in the oldest group. Another interesting result, highlighted in our previous publication on this cohort (Adams et al. NEJM 2007), was a higher mortality rate from external causes (accidents, poisonings, suicides, homicides) in surgery patients. We explored this phenomenon further by age at surgery and found that externally-caused deaths were only increased in women (not men) who had surgery before age 35.
Medical Research: What should clinicians and patients take away from your report?
Dr. Davidson: Patients who are considering bariatric surgery as a treatment for severe obesity should be encouraged that undergoing bariatric surgery is associated with a significant reduction in mortality risk across a broad age range. Extra attention should be paid to reducing potential risk of death from external causes, particularly in younger women.
Medical Research: What recommendations do you have for future research as a result of this study?
Dr. Davidson: Further investigations into the nature of the association between gastric bypass surgery and long-term survival rates in younger women are needed. Longer-term studies will be important in studying the difference in all-cause mortality between weight loss surgery and severely obese controls in the youngest age category.
Davidson LE, Adams TD, Kim J, et al. Association of Patient Age at Gastric Bypass Surgery With Long-term All-Cause and Cause-Specific Mortality. JAMA Surg.Published online February 10, 2016. doi:10.1001/jamasurg.2015.5501.
Lance Davidson, PhD (2016). Gastric Bypass Surgery Reduces Mortality Even In Older Patients