Association of Preoperative Body Weight and Weight Loss With Risk of Death After Bariatric Surgery

Yangbo Sun; Buyun Liu; Jessica K Smith; Marcelo L G Correia; Dana L Jones; Zhanyong Zhu; Adeyinka Taiwo; Lisa L Morselli; Katie Robinson; Alexander A Hart; Linda G Snetselaar; Wei Bao

doi:10.1001/jamanetworkopen.2020.4803

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Association of Preoperative Body Weight and Weight Loss With Risk of Death After Bariatric Surgery

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Association of Preoperative Body Weight and Weight Loss With Risk of Death After Bariatric Surgery

Yangbo Sun, Buyun Liu, Jessica K Smith, Marcelo L G Correia, Dana L Jones, Zhanyong Zhu, Adeyinka Taiwo, Lisa L Morselli, Katie Robinson, Alexander A Hart, …

JAMA network open, Vol.3(5), pp.e204803-e204803

05/01/2020

DOI: 10.1001/jamanetworkopen.2020.4803

PMCID: PMC7225906

PMID: 32407504

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Abstract

Perception of weight loss requirements before bariatric surgery varies among patients, physicians, and health insurance payers. Current clinical guidelines do not require preoperative weight loss because of a lack of scientific support regarding its benefits. To examine the association of preoperative body mass index (BMI) and weight loss with 30-day mortality after bariatric surgery. This cohort study used data from 480 075 patients who underwent bariatric surgery from 2015 to 2017 in the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program, which covers more than 90% of all bariatric surgery programs in the United States and Canada. Clinical and demographic data were collected at all participating institutions using a standardized protocol. Data analysis was performed from December 2018 to November 2019. Preoperative BMI and weight loss. 30-day mortality after bariatric surgery. Of the 480 075 patients (mean [SD] age 45.1 [12.0] years; 383 265 [79.8%] women), 511 deaths (0.1%) occurred within 30 days of bariatric surgery. Compared with patients with a preoperative BMI of 35.0 to 39.9, the multivariable-adjusted odds ratios for 30-day mortality for patients with preoperative BMI of 40.0 to 44.9, 45.0 to 49.9, 50.0 to 54.9, and 55.0 and greater were 1.37 (95% CI, 1.02-1.83), 2.19 (95% CI, 1.64-2.92), 2.61 (95% CI, 1.90-3.58), and 5.03 (95% CI, 3.78-6.68), respectively (P for trend < .001). Moreover, compared with no preoperative weight loss, the multivariable-adjusted odds ratios for 30-day mortality for patients with weight loss of more than 0% to less than 5.0%, 5.0% to 9.9%, and 10.0% and greater were 0.76 (95% CI, 0.60-0.96), 0.69 (95% CI, 0.53-0.90), and 0.58 (95% CI, 0.41-0.82), respectively (P for trend = .003). In this study, even moderate weight loss (ie, >0% to <5%) before bariatric surgery was associated with a lower risk of 30-day mortality. These findings may help inform future updates of clinical guidelines regarding bariatric surgery.

Details

Title: Subtitle: Association of Preoperative Body Weight and Weight Loss With Risk of Death After Bariatric Surgery
Creators: Yangbo Sun - Department of Epidemiology, University of Iowa College of Public Health, Iowa City
Buyun Liu - Department of Epidemiology, University of Iowa College of Public Health, Iowa City
Jessica K Smith - Carver College of Medicine, Department of Surgery, University of Iowa, Iowa City
Marcelo L G Correia - Fraternal Order of Eagles Diabetes Research Center, University of Iowa, Iowa City
Dana L Jones - Carver College of Medicine, Department of Surgery, University of Iowa, Iowa City
Zhanyong Zhu - Department of Plastic Surgery, Renmin Hospital of Wuhan University, Wuhan, China
Adeyinka Taiwo - Carver College of Medicine, Department of Internal Medicine, University of Iowa, Iowa City
Lisa L Morselli - Carver College of Medicine, Department of Internal Medicine, University of Iowa, Iowa City
Katie Robinson - now with Scientific and Medical Affairs, Abbott Nutrition, Columbus, Ohio
Alexander A Hart - Department of Epidemiology, University of Iowa College of Public Health, Iowa City
Linda G Snetselaar - Department of Epidemiology, University of Iowa College of Public Health, Iowa City
Wei Bao - Obesity Research and Education Initiative, University of Iowa, Iowa City
Resource Type: Journal article
Publication Details: JAMA network open, Vol.3(5), pp.e204803-e204803
DOI: 10.1001/jamanetworkopen.2020.4803
PMID: 32407504
PMCID: PMC7225906
NLM abbreviation: JAMA Netw Open
ISSN: 2574-3805
eISSN: 2574-3805
Language: English
Date published: 05/01/2020
Academic Unit: Epidemiology; Pharmaceutical Sciences and Experimental Therapeutics; Surgery; Fraternal Order of Eagles Diabetes Research Center; Endocrinology and Metabolism; Internal Medicine
Record Identifier: 9984215141602771

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