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David Arterburn, MD, MPH; Edward H. Livingston, MD, MS; Tracy Schifftner, MS; Leila C. Kahwati, MD, MPH; William G. Henderson, PhD; Matthew L. Maciejewski, PhD

Arch Surg. 2009;144(10):914-920.

Hypothesis  The purpose of this study was to examine patient factors associated with mortality among veterans who undergo bariatric surgery.

Design  Prospective study that uses data from the Veterans Affairs (VA) National Surgical Quality Improvement Program.

Setting  Group Health Center for Health Studies, the VA North Texas Health Care System, the Denver VA Medical Center, and the Durham VA Medical Center.

Patients  We identified 856 veterans who had undergone bariatric surgery in 1 of 12 VA bariatric centers from January 1, 2000, through December 31, 2006.

Main Outcome Measures  The risk of death was estimated via Cox proportional hazards.

Results  The 856 veterans had a mean body mass index (BMI) of 48.7, a mean age of 54 years, and a mean DCG score of 0.76; 73.0% were men, 83.9% were white, and 7.0% had an ASA class equal to 4. Fifty-four veterans (6.3%) had died by the end of 2006. In our Cox models, patients with a BMI greater than 50 (superobesity; hazard ratio [HR], 1.8; P = .04) or a DCG score greater than or equal to 2 (HR, 3.4; P < .001) had an increased risk of death.

Conclusion  Superobese veterans and those with a greater burden of chronic disease had a greater risk of death after bariatric surgery from 2000 through 2006.

Author Affiliations: Group Health Center for Health Studies and Department of Medicine, Division of General Internal Medicine, University of Washington, Seattle (Dr Arterburn); Division of Gastrointestinal and Endocrine Surgery, University of Texas Southwestern Medical Center, and Veterans Administration North Texas Health Care System, Dallas (Dr Livingston); Biomedical Engineering, University of Texas at Arlington (Dr Livingston); Denver Veterans Affairs Medical Center (Ms Schifftner and Dr Henderson) and Department of Preventive Medicine and Biometrics and Colorado Health Outcomes Program, Health Sciences Center, University of Colorado at Denver (Dr Henderson); National Center for Health Promotion and Disease Prevention, Office of Patient Care Services, Veterans Health Administration, Department of Veterans Affairs (Dr Kahwati), and Center for Health Services Research in Primary Care, Durham VA Medical Center (Dr Maciejewski), Durham, North Carolina; and Division of Pharmaceutical Outcomes and Policy, School of Pharmacy, University of North Carolina at Chapel Hill (Dr Maciejewski).

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Arch Surg. 2009;144(10):920.
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