Thirty-day mortality after bariatric surgery: Independently adjudicated causes of death in the longitudinal assessment of bariatric surgery

Mark D. Smith, Emma Patterson, Abdus S. Wahed, Steven H. Belle, Paul D. Berk, Anita P. Courcoulas, Gregory F. Dakin, David R. Flum, Laura MacHado, James E. Mitchell, John Pender, Alfons Pomp, Walter Pories, Ramesh Ramanathan, Beth Schrope, Myrlene Staten, Akuezunkpa Ude, Bruce M. Wolfe

Research output: Contribution to journalReview article

68 Scopus citations

Abstract

Background: Mortality following bariatric surgery is a rare event in contemporary series, making it difficult for any single center to draw meaningful conclusions as to cause of death. Nevertheless, much of the published mortality data come from single-center case series and reviews of administrative databases. These sources tend to produce lower mortality estimates than those obtained from controlled clinical trials. Furthermore, information about the causes of death and how they were determined is not always available. The aim of the present report is to describe in detail all deaths occurring within 30 days of surgery in the Longitudinal Assessment of Bariatric Surgery (LABS). Methods: LABS is a ten-center observational cohort study of bariatric surgical outcomes. Data were collected prospectively for bariatric surgeries performed between March 2005 and April 2009. All deaths occurring within 30-days of surgery were identified, and cause of death assigned by an independent Adjudication Subcommittee, blinded to operating surgeon and site. Results: Six thousand one hundred eighteen patients underwent primary bariatric surgery. Eighteen deaths (0.3%) occurred within 30-days of surgery. The most common cause of death was sepsis (33% of deaths), followed by cardiac causes (28%), and pulmonary embolism (17%). For one patient cause of death could not be determined despite examination of all available information. Conclusions: This study confirms the low 30-day mortality rate following bariatric surgery. The recognized complications of anastomotic leak, cardiac events, and pulmonary emboli accounted for the majority of 30-day deaths.

Original languageEnglish (US)
Pages (from-to)1687-1692
Number of pages6
JournalObesity Surgery
Volume21
Issue number11
DOIs
StatePublished - Nov 2011

Keywords

  • Bariatric surgery
  • Cause of death
  • Gastric bypass
  • Mortality

ASJC Scopus subject areas

  • Surgery
  • Endocrinology, Diabetes and Metabolism
  • Nutrition and Dietetics

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    Smith, M. D., Patterson, E., Wahed, A. S., Belle, S. H., Berk, P. D., Courcoulas, A. P., Dakin, G. F., Flum, D. R., MacHado, L., Mitchell, J. E., Pender, J., Pomp, A., Pories, W., Ramanathan, R., Schrope, B., Staten, M., Ude, A., & Wolfe, B. M. (2011). Thirty-day mortality after bariatric surgery: Independently adjudicated causes of death in the longitudinal assessment of bariatric surgery. Obesity Surgery, 21(11), 1687-1692. https://doi.org/10.1007/s11695-011-0497-8