Bariatric Surgery (BS) is considered a safe procedure, but there is still a risk factor for complications and mortality after the operation. According to a recent study, patient demographics that undergo obesity-treating bariatric surgery haven’t changed. This remains true despite significant changes in insurance coverage, costs, and popularity of weight loss surgery since 2007. The study also discovered that patient safety outcomes have remained stable as well.

Special attention must be given to “at-risk” BS patients who are male, older, and single, with higher BMI, mental disorders, and weight-related health issues like lung and heart problems.

Background

The study looked at U.S. Centers of Excellence by ethnicity, procedure, age, rate of complications, and outcomes. Surgeons and researchers found minor changes from 2007 to 2011. The study was presented by Dr. Ranan Sudan on behalf of the entire research committee and the Executive Council of the American Society for Metabolic and Bariatric Surgery (ASMBS) at Obesity Weekly 2013.

Another study by Dr. Sudan also found that patient safety outcomes remained unchanged since 2007, with 2% of patients having complications and just 0.1% deaths occurring. The study is being depicted as an average of these types of cases because the statistics have not changed in several years.

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Analysis

Because the data is not risk-adjusted, it is nearly impossible to compare death or complication rates across the different weight loss surgery procedures. The study’s researchers did, however, find that patients who had a higher Body Mass Index (BMI), more comorbidities, or more excess body weight tended to have the more extensive reconstructive type of procedures such as biliopancreatic diversion with duodenal switch (BPD/DS) or gastric bypass surgery.

Ranjan Sudan, MD

According to Ranjan Sudan, MD, a robotic and bariatric surgeon and vice-chair of education at Duke University Health System, this study can become an average for these types of medical cases. The study created a particular look at U.S. surgical facilities or hospitals by ethnicity, age, gender, the rate of complication, procedure, and outcome.

Demographics of uninsured or underinsured patients who travel to Mexico to get weight loss surgery from the United States or Canada are roughly:

  • 76% woman
  • 24% men

with about 80% of them ages 25 to 54 – According to a 2020 MBC Research

Weight Loss Surgery Complication Rates

The study found no increases in the number of males, individuals with diabetes or minorities who had bariatric surgery. Of the 364,000 or more patients evaluated during the study, only 1.75% had a severe adverse event during the first 30 days of their post-op period, and only 2.02% had a severe adverse event within a year. The serious one-year rate stayed close to the same average throughout the entire six-year period studied, 2.18% in 2009 and 1.66% in 2011.

Mexico Bariatric Center® incidence and mortality risk factors following weight loss surgery in 2021. Dr. Louisiana Valenzuela reported no mortality with only %0.53 overall complication rate in 2021 (total of 564 bariatric patients).

Dr Valenzuela - Mexico bariatric center 2021 complication rate

The most common comorbidities found in these patients were Type II Diabetes, musculoskeletal disorder, sleep apnea, and gastroesophageal reflux disease. Ultimately, this study remains a good “snapshot” of weight loss surgery in the United States. While the data may not reflect high-quality data often found in nonsurgical data, it does show that surgery is very safe and should be encouraging to patients to elect to continue to have the surgical procedures.

Mortality Rate of Weight Loss Surgery

Ultimately, this study’s data is not risk-adjusted, which means that it is nearly impossible to compare death or complication rates across different procedures. It is understood that patients with a higher body mass index or more excess weight undergo more extensive weight loss surgeries such as biliopancreatic diversion with duodenal switch or gastric bypass. Because of this, the researchers don’t feel that comparing complication rates across procedures will add any value to the study and its findings.

Incidence and Risk Factors for Mortality Following Bariatric Surgery

The study’s researchers believed that these adverse events and mortality rates could be used for benchmarks. They found the one-year mortality rate was:

These statistics were measured in mortality and morbidity rates. These rates remain unchanged since 2007 with just 2% of patients reporting complications and deaths only occurring in 0.1% of all surgeries.

Demographics of Weight Loss Surgery Patients

The study found there were very few changes from 2007 to 2011 during their research. Ultimately, there were no significant changes or increases in the percentage of men, diabetes patients or minorities who elected to have weight loss surgery.

Race and Ethnicity

Ultimately, this study offers a look at real-life benchmarks for bariatric surgical procedures that can be used against what surgeons suggest regarding outcomes for patients.

The study found that more Hispanic and black patients are electing to have bariatric surgery. The percentage of black patients rose from 10.11% in 2007 to 13.43% in 2011. Also, the number of Hispanics increased from 5.84 to 8.44%. Dr. Sudan reports that the increase in these minority patients is still much less than would be expected in comparison to the prevalence of obesity in that population.

While this data doesn’t reflect a significant impact, it does create a benchmark for doctors to use regarding death and mortality risks to discuss with patients before they commit to having bariatric surgery.

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