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Effects of obesity surgery on overall and disease-specific mortality in a 5-country, population-based study

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Effects of obesity surgery on overall and disease-specific mortality in a 5-country, population-based study. / Kauppila JH; Tao W; Santoni G; von Euler-Chelpin M; Lynge E; Tryggvadóttir L; Ness-Jensen E; Romundstad P; Pukkala E ; Lagergren, Jesper.

In: Gastroenterology, Vol. 157, No. 1, 01.07.2019, p. 119-127.e1.

Research output: Contribution to journalArticle

Harvard

Kauppila JH, Tao W, Santoni G, von Euler-Chelpin M, Lynge E, Tryggvadóttir L, Ness-Jensen E, Romundstad P, Pukkala E & Lagergren, J 2019, 'Effects of obesity surgery on overall and disease-specific mortality in a 5-country, population-based study', Gastroenterology, vol. 157, no. 1, pp. 119-127.e1. https://doi.org/10.1053/j.gastro.2019.03.048

APA

Kauppila JH, Tao W, Santoni G, von Euler-Chelpin M, Lynge E, Tryggvadóttir L, Ness-Jensen E, Romundstad P, Pukkala E, & Lagergren, J. (2019). Effects of obesity surgery on overall and disease-specific mortality in a 5-country, population-based study. Gastroenterology, 157(1), 119-127.e1. https://doi.org/10.1053/j.gastro.2019.03.048

Vancouver

Kauppila JH, Tao W, Santoni G, von Euler-Chelpin M, Lynge E, Tryggvadóttir L et al. Effects of obesity surgery on overall and disease-specific mortality in a 5-country, population-based study. Gastroenterology. 2019 Jul 1;157(1):119-127.e1. https://doi.org/10.1053/j.gastro.2019.03.048

Author

Kauppila JH ; Tao W ; Santoni G ; von Euler-Chelpin M ; Lynge E ; Tryggvadóttir L ; Ness-Jensen E ; Romundstad P ; Pukkala E ; Lagergren, Jesper. / Effects of obesity surgery on overall and disease-specific mortality in a 5-country, population-based study. In: Gastroenterology. 2019 ; Vol. 157, No. 1. pp. 119-127.e1.

Bibtex Download

@article{de5ca923d06a44028641610a7db2751d,
title = "Effects of obesity surgery on overall and disease-specific mortality in a 5-country, population-based study",
abstract = "Background & Aims Bariatric surgery might reduce overall mortality from obesity. We investigated whether survival times of patients who have undergone bariatric surgery are similar to those of the general population levels and are longer than in obese individuals who did not receive surgery. Methods We performed a population-based cohort study of persons with a diagnosis of obesity listed in nationwide registries from Nordic countries, from 1980 through 2012. Bariatric surgery was analyzed in relation to all-cause mortality and the obesity-related morbidities cardiovascular disease, diabetes, cancer, and suicide. Poisson models provided standardized mortality ratios (SMRs) with 95% CIs. Multivariable Cox regression provided hazard ratios (HRs) for mortality in operated and non-operated participants. Results Among 505,258 participants, 49,977 underwent bariatric surgery. Overall all-cause SMR was increased after surgery (1.94; 95% CI, 1.83–2.05) and increased with longer follow up, to 2.28 (95% CI, 2.07–2.51) ≥15 years post-surgery. SMRs were increased for cardiovascular disease (2.39; 95% CI, 2.17–2.63), diabetes (3.67; 95% CI, 2.85–4.72), and suicide (2.39; 95% CI, 1.96–2.92), but not for cancer (1.05; 95% CI, 0.95–1.17); SMRs increased with time. In non-operated obese participants, all-cause SMR was 2.15 (95% CI, 2.11–2.20), which remained stable during follow up. Compared to non-operated obese participants, patients who underwent bariatric surgery had decreased overall mortality from all causes (HR, 0.63; 95% CI, 0.60–0.66), cardiovascular disease (HR, 0.57; 95% CI, 0.52–0.63), and diabetes (HR, 0.38; 95% CI, 0.29–0.49), but increased mortality from suicide (HR, 1.68; 95% CI, 1.32–2.14). Cancer mortality was decreased overall (HR, 0.84; 95% CI, 0.76–0.93), but increased ≥15 years of follow up (HR, 1.20; 95% CI, 1.02–1.42). Conclusions In a study of persons with a diagnosis of obesity listed in nationwide registries of Nordic countries, we found that obese patients who undergo bariatric surgery have longer survival times than non-operated obese individuals, but their mortality is higher than that of the general population and increases with time. Obesity-related morbidities could account for these findings.",
keywords = "Gastric Bypass, Metabolic Syndrome, NordOSCO, Outcome",
author = "{Kauppila JH} and {Tao W} and {Santoni G} and {von Euler-Chelpin M} and {Lynge E} and {Tryggvad{\'o}ttir L} and {Ness-Jensen E} and {Romundstad P} and {Pukkala E} and Jesper Lagergren",
year = "2019",
month = jul,
day = "1",
doi = "10.1053/j.gastro.2019.03.048",
language = "English",
volume = "157",
pages = "119--127.e1",
journal = "Gastroenterology",
issn = "0016-5085",
number = "1",

}

RIS (suitable for import to EndNote) Download

TY - JOUR

T1 - Effects of obesity surgery on overall and disease-specific mortality in a 5-country, population-based study

AU - Kauppila JH

AU - Tao W

AU - Santoni G

AU - von Euler-Chelpin M

AU - Lynge E

AU - Tryggvadóttir L

AU - Ness-Jensen E

AU - Romundstad P

AU - Pukkala E

AU - Lagergren, Jesper

PY - 2019/7/1

Y1 - 2019/7/1

N2 - Background & Aims Bariatric surgery might reduce overall mortality from obesity. We investigated whether survival times of patients who have undergone bariatric surgery are similar to those of the general population levels and are longer than in obese individuals who did not receive surgery. Methods We performed a population-based cohort study of persons with a diagnosis of obesity listed in nationwide registries from Nordic countries, from 1980 through 2012. Bariatric surgery was analyzed in relation to all-cause mortality and the obesity-related morbidities cardiovascular disease, diabetes, cancer, and suicide. Poisson models provided standardized mortality ratios (SMRs) with 95% CIs. Multivariable Cox regression provided hazard ratios (HRs) for mortality in operated and non-operated participants. Results Among 505,258 participants, 49,977 underwent bariatric surgery. Overall all-cause SMR was increased after surgery (1.94; 95% CI, 1.83–2.05) and increased with longer follow up, to 2.28 (95% CI, 2.07–2.51) ≥15 years post-surgery. SMRs were increased for cardiovascular disease (2.39; 95% CI, 2.17–2.63), diabetes (3.67; 95% CI, 2.85–4.72), and suicide (2.39; 95% CI, 1.96–2.92), but not for cancer (1.05; 95% CI, 0.95–1.17); SMRs increased with time. In non-operated obese participants, all-cause SMR was 2.15 (95% CI, 2.11–2.20), which remained stable during follow up. Compared to non-operated obese participants, patients who underwent bariatric surgery had decreased overall mortality from all causes (HR, 0.63; 95% CI, 0.60–0.66), cardiovascular disease (HR, 0.57; 95% CI, 0.52–0.63), and diabetes (HR, 0.38; 95% CI, 0.29–0.49), but increased mortality from suicide (HR, 1.68; 95% CI, 1.32–2.14). Cancer mortality was decreased overall (HR, 0.84; 95% CI, 0.76–0.93), but increased ≥15 years of follow up (HR, 1.20; 95% CI, 1.02–1.42). Conclusions In a study of persons with a diagnosis of obesity listed in nationwide registries of Nordic countries, we found that obese patients who undergo bariatric surgery have longer survival times than non-operated obese individuals, but their mortality is higher than that of the general population and increases with time. Obesity-related morbidities could account for these findings.

AB - Background & Aims Bariatric surgery might reduce overall mortality from obesity. We investigated whether survival times of patients who have undergone bariatric surgery are similar to those of the general population levels and are longer than in obese individuals who did not receive surgery. Methods We performed a population-based cohort study of persons with a diagnosis of obesity listed in nationwide registries from Nordic countries, from 1980 through 2012. Bariatric surgery was analyzed in relation to all-cause mortality and the obesity-related morbidities cardiovascular disease, diabetes, cancer, and suicide. Poisson models provided standardized mortality ratios (SMRs) with 95% CIs. Multivariable Cox regression provided hazard ratios (HRs) for mortality in operated and non-operated participants. Results Among 505,258 participants, 49,977 underwent bariatric surgery. Overall all-cause SMR was increased after surgery (1.94; 95% CI, 1.83–2.05) and increased with longer follow up, to 2.28 (95% CI, 2.07–2.51) ≥15 years post-surgery. SMRs were increased for cardiovascular disease (2.39; 95% CI, 2.17–2.63), diabetes (3.67; 95% CI, 2.85–4.72), and suicide (2.39; 95% CI, 1.96–2.92), but not for cancer (1.05; 95% CI, 0.95–1.17); SMRs increased with time. In non-operated obese participants, all-cause SMR was 2.15 (95% CI, 2.11–2.20), which remained stable during follow up. Compared to non-operated obese participants, patients who underwent bariatric surgery had decreased overall mortality from all causes (HR, 0.63; 95% CI, 0.60–0.66), cardiovascular disease (HR, 0.57; 95% CI, 0.52–0.63), and diabetes (HR, 0.38; 95% CI, 0.29–0.49), but increased mortality from suicide (HR, 1.68; 95% CI, 1.32–2.14). Cancer mortality was decreased overall (HR, 0.84; 95% CI, 0.76–0.93), but increased ≥15 years of follow up (HR, 1.20; 95% CI, 1.02–1.42). Conclusions In a study of persons with a diagnosis of obesity listed in nationwide registries of Nordic countries, we found that obese patients who undergo bariatric surgery have longer survival times than non-operated obese individuals, but their mortality is higher than that of the general population and increases with time. Obesity-related morbidities could account for these findings.

KW - Gastric Bypass

KW - Metabolic Syndrome

KW - NordOSCO

KW - Outcome

UR - http://www.scopus.com/inward/record.url?scp=85066085079&partnerID=8YFLogxK

U2 - 10.1053/j.gastro.2019.03.048

DO - 10.1053/j.gastro.2019.03.048

M3 - Article

VL - 157

SP - 119-127.e1

JO - Gastroenterology

JF - Gastroenterology

SN - 0016-5085

IS - 1

ER -

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