In the July issue of the New England Journal of Medicine (NEJM 361(5):445-454; July 30, 2009), a study coordinated in the Epidemiology Data Center indicates that weight loss surgery is safer than once believed.
The Longitudinal Assessment of Bariatric Surgery (LABS) study found that for every 1000 surgery patients, three died within 30 days of surgery and 43 had a major complication. A 30-day mortality rate of 0.3% is considerably lower than the 20 or so deaths per 1000 patients found by other studies just a few years prior.
The LABS study followed 4,776 patients from 2005 to 2007, tracking their health before, during, and after surgery. In addition to tracking mortality rates, the study also tracked data on surgical complications and which patients were most likely to encounter them. Major complications such as deep vein thrombosis or pulmonary embolism occurred in approximately 4% of patients. Characteristics increasing the chances of a complication within 30 days of surgery were a history of blood clots, diagnosis of sleep apnea, difficulty walking 200 feet or were extreme obesity.
In an interview with ABC News, LABS Steering Committee Chair Dr. Bruce Wolfe, M.D., Professor of Surgery at Oregon Health & Science University, noted that "the basic finding is that bariatric surgery as done in the centers participating in the NIH consortium is safe -- not perfect." He added that as major surgery goes, the risks of complications are also "very low."
While the results of this study are encouraging, an accompanying NEJM editorial by Dr. Malcolm Robinson cautions prospective patients and surgeons to consider the financial implications of surgery, warning "perioperative costs outstrip any nonsurgical treatment...and expense of operating on the millions of potentially eligible obese adults could overwhelm an already financially stressed health care system."
Dr. Steven Belle, Professor of Epidemiology and of Biostatistics, is the Principal Investigator of the Data Coordinating Center for this study.
For more information on LABS, go to the web site at http://www.niddklabs.org