Surgery decreases long-term mortality, morbidity, and health care use in morbidly obese patients

Nicolas V. Christou, John S. Sampalis, Moishe Liberman, Didier Look, Stephane Auger, Alexander P H McLean, Lloyd D. MacLean, Walter J. Pories, Bruce Wolfe, Richard C. Thirlby

Research output: Contribution to journalArticle

958 Citations (Scopus)

Abstract

Objective: This study tested the hypothesis that weight-reduction (bariatric) surgery reduces long-term mortality in morbidly obese patients. Background: Obesity is a significant cause of morbidity and mortality. The impact of surgically induced, long-term weight loss on this mortality is unknown. Methods: We used an observational 2-cohort study. The treatment cohort (n = 1035) included patients having undergone bariatric surgery at the McGill University Health Centre between 1986 and 2002. The control group (n = 5746) included age- and gender-matched severely obese patients who had not undergone weight-reduction surgery identified from the Quebec provincial health insurance database. Subjects with medical conditions (other then morbid obesity) at cohort-inception into the study were excluded. The cohorts were followed for a maximum of 5 years from inception. Results: The cohorts were well matched for age, gender, and duration of follow-up. Bariatric surgery resulted in significant reduction in mean percent excess weight loss (67.1%, P <0.001). Bariatric surgery patients had significant risk reductions for developing cardiovascular, cancer, endocrine, infectious, psychiatric, and mental disorders compared with controls, with the exception of hematologic (no difference) and digestive diseases (increased rates in the bariatric cohort). The mortality rate in the bariatric surgery cohort was 0.68% compared with 6.17% in controls (relative risk 0.11, 95% confidence interval 0.04-0.27), which translates to a reduction in the relative risk of death by 89%. Conclusions: This study shows that weight-loss surgery significantly decreases overall mortality as well as the development of new health-related conditions in morbidly obese patients.

Original languageEnglish (US)
Pages (from-to)416-424
Number of pages9
JournalAnnals of Surgery
Volume240
Issue number3
DOIs
StatePublished - Sep 2004
Externally publishedYes

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Bariatric Surgery
Weight Loss
Morbidity
Delivery of Health Care
Mortality
Endocrine Gland Neoplasms
Bariatrics
Morbid Obesity
Quebec
Health
Risk Reduction Behavior
Health Insurance
Mental Disorders
Psychiatry
Cohort Studies
Obesity
Databases
Confidence Intervals
Control Groups

ASJC Scopus subject areas

  • Surgery

Cite this

Christou, N. V., Sampalis, J. S., Liberman, M., Look, D., Auger, S., McLean, A. P. H., ... Thirlby, R. C. (2004). Surgery decreases long-term mortality, morbidity, and health care use in morbidly obese patients. Annals of Surgery, 240(3), 416-424. https://doi.org/10.1097/01.sla.0000137343.63376.19

Surgery decreases long-term mortality, morbidity, and health care use in morbidly obese patients. / Christou, Nicolas V.; Sampalis, John S.; Liberman, Moishe; Look, Didier; Auger, Stephane; McLean, Alexander P H; MacLean, Lloyd D.; Pories, Walter J.; Wolfe, Bruce; Thirlby, Richard C.

In: Annals of Surgery, Vol. 240, No. 3, 09.2004, p. 416-424.

Research output: Contribution to journalArticle

Christou, NV, Sampalis, JS, Liberman, M, Look, D, Auger, S, McLean, APH, MacLean, LD, Pories, WJ, Wolfe, B & Thirlby, RC 2004, 'Surgery decreases long-term mortality, morbidity, and health care use in morbidly obese patients', Annals of Surgery, vol. 240, no. 3, pp. 416-424. https://doi.org/10.1097/01.sla.0000137343.63376.19
Christou, Nicolas V. ; Sampalis, John S. ; Liberman, Moishe ; Look, Didier ; Auger, Stephane ; McLean, Alexander P H ; MacLean, Lloyd D. ; Pories, Walter J. ; Wolfe, Bruce ; Thirlby, Richard C. / Surgery decreases long-term mortality, morbidity, and health care use in morbidly obese patients. In: Annals of Surgery. 2004 ; Vol. 240, No. 3. pp. 416-424.
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AU - Auger, Stephane

AU - McLean, Alexander P H

AU - MacLean, Lloyd D.

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AU - Wolfe, Bruce

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N2 - Objective: This study tested the hypothesis that weight-reduction (bariatric) surgery reduces long-term mortality in morbidly obese patients. Background: Obesity is a significant cause of morbidity and mortality. The impact of surgically induced, long-term weight loss on this mortality is unknown. Methods: We used an observational 2-cohort study. The treatment cohort (n = 1035) included patients having undergone bariatric surgery at the McGill University Health Centre between 1986 and 2002. The control group (n = 5746) included age- and gender-matched severely obese patients who had not undergone weight-reduction surgery identified from the Quebec provincial health insurance database. Subjects with medical conditions (other then morbid obesity) at cohort-inception into the study were excluded. The cohorts were followed for a maximum of 5 years from inception. Results: The cohorts were well matched for age, gender, and duration of follow-up. Bariatric surgery resulted in significant reduction in mean percent excess weight loss (67.1%, P <0.001). Bariatric surgery patients had significant risk reductions for developing cardiovascular, cancer, endocrine, infectious, psychiatric, and mental disorders compared with controls, with the exception of hematologic (no difference) and digestive diseases (increased rates in the bariatric cohort). The mortality rate in the bariatric surgery cohort was 0.68% compared with 6.17% in controls (relative risk 0.11, 95% confidence interval 0.04-0.27), which translates to a reduction in the relative risk of death by 89%. Conclusions: This study shows that weight-loss surgery significantly decreases overall mortality as well as the development of new health-related conditions in morbidly obese patients.

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