In a recent study, a team of researchers from The University of Virginia Health System, United States, found that Gastric bypass surgery provides long-term survival advantage compared to non-surgical propensity-matched controls. The study entitled “Gastric Bypass Improves Survival Compared to Propensity-Matched Controls: A Cohort Study with Over 10 Year Follow up”, was recently published in the The American Journal of Surgery.
According to the National Health and Nutrition Examination Survey (NHANES), the prevalence of adult obesity in the United States in 2012 was 34.9%, with a consistent trend. However, other estimates of adult obesity indicate that the condition can end up affecting as many as 51% of adults by 2030. These high estimates have prompted the United States Department of Health and Human Services to classify obesity as a fundamental health concern, and set the goal of reducing condition rates by the year 2020.
Bariatric surgery improves survival in the obese population, however studies evaluating long-term (> 10 year) outcomes after patients undergo bariatric surgery are lacking. Given the evidence gap, Christopher Guidry and colleagues created a historical cohort of gastric bypass cases and propensity-matched controls, and evaluated long-term mortality in both diabetic and non-diabetic patients.
A total of 430 GBP cases and 5,323 controls were identified between 2002 and 2003. Patients were then classified as either “cases” or “controls” based upon receipt of a roux-en-y gastric bypass. The team of researchers performed propensity matching using the Kaplan-Meier curves method. Of the total sample, results revealed that 802 cases and controls were identified using propensity matching, with a similar median follow-up (approximately 12 years).
Data analysis revealed that patients who received a gastric bypass had significantly lower rates of overall mortality (6.5% vs. 12.7%) than matched comparators. Furthermore, the GBP group demonstrated significantly increased survival when compared to controls. The analysis also showed similar patterns among diabetics.
The authors indicated that gastric bypass surgery provides long-term survival advantage compared to non-surgical propensity-matched controls. This was the first study of true long-term mortality in gastric-bypass patients using a propensity-matched analysis. The authors are encouraged by the results, which add evidence to the growing agreement that bariatric bypass surgery is a “gold standard” of care for reducing long-term mortality in obese and morbidly obese patients.