Last Updated: 2007-10-15 19:02:47 -0400 (Reuters Health)

NEW YORK (Reuters Health) – The death rates for patients who have undergone bariatric surgery are higher than those seen in the general population, matched for age and sex, new research shows. In particular, there is an excess of deaths due to suicide and coronary heart disease in these patients.

As reported in the Archives of Surgery for October, the study involved an analysis of data for all Pennsylvania residents who underwent a bariatric operation between 1995 and 2004. Mortality outcomes in these patients were compared with those seen in the general population.

A total of 440 deaths were noted after 16,683 bariatric procedures that were performed during the study period, senior author Dr. Lewis H. Kuller, from the University of Pittsburgh, and colleagues note. Male gender and advancing age were both associated with increased mortality.

At 1 year, the case mortality rate was roughly 1%, and at 5 years, it was almost 6%, the report indicates.

For all age groups, the death rate was much higher in bariatric surgery patients than in the general population. The difference was particularly pronounced for patients between 25 and 34 years of age. In this group, the death rates for male and female patients were 13.8 and 5.0 per 1000 person-years, respectively, compared with rates of 1.3 and 0.6 per 1000 person-years in the general population.

The main cause of death, noted in 76 cases, was coronary heart disease, the report indicates. Of the 45 deaths from traumatic causes, 16 were suicides and 14 were drug overdoses not attributed to suicide. Based on data from the general population, the authors estimate that only three suicide deaths should have occurred.

"It is likely that this continued excess mortality after bariatric surgery could be reduced by better coordination of follow-up after the surgery, especially control of high risk factors such as hypertension, diabetes mellitus, hyperlipidemia, and smoking as well as efforts to prevent weight regain by diet and exercise, and psychological support to treat depression and prevent suicide," the researchers conclude.

Arch Surg 2007;142:923-928.