• Colette S Inaba, Christina Y Koh, Sarath Sujatha-Bhaskar, Jack P Silva, Yanjun Chen, Danh V Nguyen, and Ninh T Nguyen.
• Department of Surgery, University of California Irvine Medical Center, Orange, CA.
• J. Am. Coll. Surg. 2018 Jun 1; 226 (6): 1166-1174.

BackgroundContemporary mortality after bariatric surgery is low and has been decreasing over the past 2 decades. Most studies have reported inpatient or 30-day mortality, which may not represent the true risk of bariatric surgery. The objective of this study was to examine 1-year mortality and factors predictive of 1-year mortality after contemporary laparoscopic bariatric surgery.Study DesignUsing the 2008 to 2012 Bariatric Outcomes Longitudinal Database (BOLD), data from 158,606 operations were analyzed, including 128,349 (80.9%) laparoscopic Roux-en-Y gastric bypass (LRYGB) and 30,257 (19.1%) laparoscopic sleeve gastrectomy (LSG) operations. Multivariate logistic regression was used to determine independent risk factors associated with 1-year mortality for each type of procedure.ResultsThe 30-day and 1-year mortality rates for LRYGB were 0.13% and 0.23%, respectively, and for LSG were 0.06% and 0.11%, respectively. Risk factors for 1-year mortality included older age (LRYGB: adjusted odds ratio [AOR] 1.05 per year, p < 0.001; LSG: AOR 1.08 per year, p < 0.001); male sex (LRYGB: AOR 1.88, p < 0.001); higher BMI (LRYGB: AOR 1.04 per unit, p < 0.001; LSG: AOR 1.05 per unit, p = 0.009); and the presence of 30-day leak (LRYGB: AOR 25.4, p < 0.001; LSG: AOR 35.8, p < 0.001), 30-day pulmonary embolism (LRYGB: AOR 34.5, p < 0.001; LSG: AOR 252, p < 0.001), and 30-day hemorrhage (LRYGB: AOR 2.34, p = 0.001).ConclusionsContemporary 1-year mortality after laparoscopic bariatric surgery is much lower than previously reported, at <0.25%. It is important to continually refine techniques and perioperative management in order to minimize leaks, hemorrhage, and pulmonary embolus after bariatric surgery because these complications contribute to a higher risk of mortality.Copyright © 2018 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

15 keywords...

hide…