Bariatric surgery is associated with a reduced risk of mortality in morbidly obese patients with a history of major cardiovascular events

Am Surg. 2012 Jun;78(6):685-92.


Although the safety of bariatric surgery in patients with established cardiovascular disease has been demonstrated, little is known about the mid- to long-term survival of these patients after surgery. We conducted a retrospective cohort study of bariatric surgical patients (n = 349) compared with morbidly obese surgical controls (n = 903). Data were obtained on all patients 40 to 79 years of age, from 1996 to 2008, with a diagnosis code of morbid obesity, a primary surgical procedure of interest, and a cardiovascular event history. Data sources were the statewide South Carolina UB92 inpatient hospitalization database and death records. The primary outcome was all-cause mortality. A total of 349 bariatric and 903 control patients with cardiovascular event histories were identified. Among bariatric patients, 19 deaths occurred in 986 person-years of follow-up versus 150 deaths among controls in 3138 person-years of follow-up. Unadjusted all-cause mortality was estimated at 7 ± 2 per cent at 5 years in bariatric patients compared with 19 ± 2 per cent (P < 0.001) in controls. Adjusting for age, comorbidities, and event history, the relative risk of mortality was reduced by 40 per cent in bariatric patients compared with controls [hazard ratios (95% confidence interval): 0.60 (0.36, 0.99)]. In patients with a history of cardiovascular events, bariatric surgery is associated with a significantly decreased risk of all-cause mortality.

Publication types

  • Comparative Study
  • Multicenter Study

MeSH terms

  • Adult
  • Aged
  • Bariatric Surgery*
  • Cardiovascular Diseases / complications
  • Cardiovascular Diseases / epidemiology*
  • Cause of Death / trends
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Morbidity / trends
  • Obesity, Morbid / complications
  • Obesity, Morbid / surgery*
  • Prognosis
  • Retrospective Studies
  • Risk Assessment / methods*
  • Risk Factors
  • South Carolina / epidemiology
  • Weight Loss