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Reduced All-Cause Mortality for Obese Patients After Bariatric Sx

TUESDAY, Jan. 16, 2018 -- Obese patients who undergo bariatric surgery have reduced all-cause mortality; and obese adults with type 2 diabetes who undergo gastric bypass have improved outcomes compared with lifestyle and intensive medical management alone, according to two studies published in the Jan. 16 issue of the Journal of the American Medical Association, a theme issue on obesity.

Orna Reges, Ph.D., from the Clalit Research Institute in Tel Aviv, Israel, and colleagues examined mortality and other outcomes among 8,385 obese patients who underwent bariatric surgery (laparoscopic banding, 3,635 patients; gastric bypass, 1,388 patients; and laparoscopic sleeve gastrectomy, 3,362 patients) who were matched with 25,155 nonsurgical patients. The researchers found that deaths occurred in 1.3 percent of surgical patients and 2.3 percent of nonsurgical patients in a median follow-up of 4.3 and 4.0 years, respectively. The absolute difference in the surgical versus nonsurgical group was 2.51 fewer deaths/1,000 person-years.

Sayeed Ikramuddin, M.D., from the University of Minnesota in Minneapolis, and colleagues compared the durability of Roux-en-Y gastric bypass added to intensive lifestyle and medical management in achieving diabetes control targets in 120 patients with a hemoglobin A1c (HbA1c) level of 8.0 percent or higher and a body mass index between 30.0 and 39.9 kg/m². The researchers found that 23 percent of patients in the gastric bypass group and 4 percent in the lifestyle-intensive medical management group had achieved the composite triple end point (HbA1c <7.0 percent, low-density lipoprotein cholesterol <100 mg/dL, and systolic blood pressure <130 mm Hg) at five years.

"Further follow-up is needed to understand the durability of the improvement," Ikramuddin and colleagues write.

Several authors from the Ikramuddin study disclosed financial ties to the pharmaceutical and medical device industries.

Abstract/Full Text - Reges (subscription or payment may be required)
Abstract/Full Text - Ikramuddin (subscription or payment may be required)
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Posted: January 2018