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

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 preoperati...

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Bibliographic Details
Published in:JAMA network open 2020-05, Vol.3 (5), p.e204803-e204803
Main Authors: Sun, Yangbo, Liu, Buyun, Smith, Jessica K, Correia, Marcelo L G, Jones, Dana L, Zhu, Zhanyong, Taiwo, Adeyinka, Morselli, Lisa L, Robinson, Katie, Hart, Alexander A, Snetselaar, Linda G, Bao, Wei
Format: Article
Language:English
Subjects:
Body mass index
Gastrointestinal surgery
Mortality
Online Only
Original Investigation
Surgery
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Summary: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 0% to
ISSN:2574-3805
2574-3805
DOI:10.1001/jamanetworkopen.2020.4803