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. 2007 Apr;11(4):500-7.
doi: 10.1007/s11605-007-0117-z.

Factors affecting morbidity and mortality of Roux-en-Y gastric bypass for clinically severe obesity: an analysis of 1,000 consecutive open cases by a single surgeon

Louis Flancbaum  1 , Scott Belsley
Affiliations

Factors affecting morbidity and mortality of Roux-en-Y gastric bypass for clinically severe obesity: an analysis of 1,000 consecutive open cases by a single surgeon

Louis Flancbaum et al. J Gastrointest Surg. 2007 Apr.

Abstract

Introduction: Determinants of perioperative risk for RYGB are not well defined.

Methods: Retrospective analysis of comorbidities was used to evaluate predictors of perioperative risk in 1,000 consecutive patients having open RYGB by univariate analyses and logistic regression.

Results: One hundred forty-six men, 854 women; average age 38.3+/-11.2 years; mean BMI 51.8+/-10.5 (range 24-116) were evaluated. Average hospital stay (LOS) was 3.8 days; 87%<3 days. 91.3% of procedures were without major complication. The most common complications were incisional hernia 3.5%, intestinal obstruction 1.9%, and leak 1.6%. 31 patients required reoperation within 30 days (3.1%). A 30-day mortality was 1.2%. Logistic regression evaluating predictors of operative mortality correlated strongly with coronary artery disease (CAD) (p<0.01), sleep apnea (p=0.03), and age (p=0.042). BMI>50 (0.6 vs 2.3%, p=0.03) and male sex were associated with increased mortality (1.3 vs. 4.0%, p=0.02). Sex-specific logistic regression demonstrated males with angiographically proven CAD were more likely to die (p=0.028) than matched cohorts. Age (p=0.033) and sleep apnea (p=0.040) were significant predictors of death for women.

Conclusion: Perioperative mortality after RYGB appears to be affected by sex, BMI, age, CAD, and sleep apnea. Strategies employing risk stratification should be developed for bariatric surgery.

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