Short‐ and long‐term mortality after bariatric surgery: A systematic review and meta‐analysis

Aims The objective of this study was to investigate short‐ (≤ 30 days) and long‐term (≥ 2 years) all‐cause mortality after bariatric surgery among adult patients with obesity. Materials and methods For short‐term mortality, eligible studies comprised randomized controlled trials (RCTs) reporting per...

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Bibliographic Details
Published in:Diabetes, obesity & metabolism obesity & metabolism, 2017-09, Vol.19 (9), p.1223-1232
Main Authors: Cardoso, Luís, Rodrigues, Dírcea, Gomes, Leonor, Carrilho, Francisco
Format: Article
Language:English
Subjects:
bariatric surgery
Bariatric Surgery - adverse effects
Bariatric Surgery - mortality
Bayesian analysis
Cancer
Cardiovascular diseases
Cardiovascular Diseases - epidemiology
Cardiovascular Diseases - mortality
Clinical trials
Comorbidity
Evidence-Based Medicine
Gastrointestinal surgery
Health risk assessment
Humans
Mathematical models
Meta-analysis
Middle Aged
Mortality
Neoplasms - epidemiology
Neoplasms - mortality
Obesity
obesity therapy
Obesity, Morbid - epidemiology
Obesity, Morbid - mortality
Obesity, Morbid - surgery
Observational Studies as Topic
Postoperative Complications - mortality
Postoperative Complications - prevention & control
Randomized Controlled Trials as Topic
Short term
Surgery
Systematic review
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Summary:Aims The objective of this study was to investigate short‐ (≤ 30 days) and long‐term (≥ 2 years) all‐cause mortality after bariatric surgery among adult patients with obesity. Materials and methods For short‐term mortality, eligible studies comprised randomized controlled trials (RCTs) reporting perioperative mortality. For long‐term mortality, eligible studies comprised RCTs and observational studies comparing mortality between obese patients after bariatric surgery and non‐operated controls. Random‐effects models using a Bayesian or frequentist approach were used to pool effect estimates of short‐ and long‐term mortality, respectively. Results Short‐term all‐cause mortality based on 38 RCTs involving 4030 patients was 0.18% (95% CI, 0.04%‐0.38%) and was higher for open surgeries (0.31%; 95% CI, 0.03%‐0.97%) and similar in mixed surgeries (0.17%; 95% CI, 0.03%‐0.43%) and restrictive surgeries (0.17%; 95% CI, 0.03%‐0.45%). For long‐term mortality, 12 observational studies involving 27 258 operated patients and 97 154 non‐operated obese controls were included. Of these, 8 studies were eligible for the meta‐analysis, which showed a reduction of 41% in all‐cause mortality (hazard ratio, 0.59; 95% CI, 0.52‐0.67; P 
ISSN:1462-8902
1463-1326
DOI:10.1111/dom.12922