Long-term mortality of patients submitted to Roux-en-Y gastric bypass in Public Health System: high prevalence of alcoholic cirrhosis and suicides.

BACKGROUND

Bariatric surgery is a valuable therapeutic option to severe obesity. Many researches have assessed the procedure efficiency on weight reduction, improvement in comorbidities and reduction of mortality. However, studies of late mortality and its causes are still necessary, mainly in the Brazilian population.

AIM: To assess late mortality, discriminating causes of death and its association with pre-operative characteristics in a series of patients submitted to bariatric surgery.

METHODS

Data analyses of 248 patients submitted to Roux-en-Y gastric bypass through Public Health System, from one up to 12 years of follow-up. The analyzed variables were: gender, age by the time of the surgery, pre-operative body mass index, comorbidities and smoking. The information about mortality was obtained through the Mortality Information System. The deaths were categorized according to International Classification of Diseases 10 and statistics analysis was done through the software STATA TM 9.2.

RESULTS

There were nine deaths, five of them were female. The mean age of the patients who died was 48.3 ± 8.4 years and the pre-operative body mass index was 56.0 ± 7.4 kg/m². The causes of death were: alcoholic cirrhosis (n=2), suicide (n=2), infectious causes (n=2), respiratory insufficiency (n=1), agranulocytosis (n=1) and unknown causes (n=1). None of the deaths was directly related to the surgery and there was no association of the pre-operative characteristics in mortality.

CONCLUSION

There was not any association between late mortality and pre-operative characteristics. The high frequency of suicide and alcoholic cirrhosis mortality indicates the strict follow-up concerns, with appropriate psychological support to the patients.