Predictors of Long-term Mortality After Bariatric Surgery Performed in Veterans Affairs Medical Centers

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 aDCGscore 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.