Predictors of long-term mortality after bariatric surgery performed in Veterans Affairs medical centers

Abstract

Hypothesis: The purpose of this study was to examine patient factors associated with mortality among veterans who undergo bariatric surgery.

Design: Prospective study that uses data from the Veterans Affairs (VA) National Surgical Quality Improvement Program.

Setting: Group Health Center for Health Studies, the VA North Texas Health Care System, the Denver VA Medical Center, and the Durham VA Medical Center.

Patients: We identified 856 veterans who had undergone bariatric surgery in 1 of 12 VA bariatric centers from January 1, 2000, through December 31, 2006.

Main outcome measures: The risk of death was estimated via Cox proportional hazards.

Results: The 856 veterans had a mean body mass index (BMI) of 48.7, a mean age of 54 years, and a mean DCG score of 0.76; 73.0% were men, 83.9% were white, and 7.0% had an ASA class equal to 4. Fifty-four veterans (6.3%) had died by the end of 2006. In our Cox models, patients with a BMI greater than 50 (superobesity; hazard ratio [HR], 1.8; P = .04) or a DCG score greater than or equal to 2 (HR, 3.4; P < .001) had an increased risk of death.

Conclusion: Superobese veterans and those with a greater burden of chronic disease had a greater risk of death after bariatric surgery from 2000 through 2006.