Low overall mortality during 10 years of bariatric surgery: nationwide study on 63,469 procedures from the Scandinavian Obesity Registry

Bariatric surgery results in an improvement in quality of life, co-morbid diseases, and an increased life expectancy. However, to obtain these benefits perioperative mortality rates need to be low. Evaluate 90-day and 1-year mortality after bariatric surgery in Sweden from 2008 to 2017. National quality register. Data on applicable patients from the Scandinavian Obesity Surgery Registry, including 63,469 patients (85.1% gastric bypass, 12.5% sleeve gastrectomy, .8% duodenal switch, .5% minor revisions, and 1.1% other procedures), were retrieved and matched to the Cause of Death registry. During the 10-year period, 36 patients died within 90 days, resulting in a .06% overall mortality. The 1-year mortality rate was .19% (n = 111). Both mortality rates decreased over the study period. In a multivariate analysis, depression (odds ratio [OR] 2.38, [95% confidence interval 1.48–3.84]), leakage (OR 9.32 [4.85–17.94]), and thromboembolic events (OR 7.60 [1.63–35.37]) increased mortality risks at both 90 days and 1 year, whereas age (OR 1.03 [1.01–1.06] per increased year of age) and abdominal circumference (OR 1.03 [1.01–1.05] per cm) were also associated with increased mortality at 1 year. The predictive value of the Obesity Surgery Mortality Risk Score was confirmed. The low 90-day and 1-year mortality, .06% and .19%, respectively, demonstrates that bariatric surgery in Sweden is safe. The use of antidepressants and 2 serious postoperative complications were the most significant risk factors for early deaths, while increased age and preoperative abdominal circumference also contributed at 1 year. •The early (30- and 90-day) and one-year mortality rates were low•Depression, leakage and thromboembolic events increased early mortality risks•In addition, age and abdominal circumference predicted mortality at one year•The low mortality rates demonstrate that bariatric surgery in Sweden is safe