(Press-News.org) The use of bariatric surgery among older, severely obese patients was not associated with a decreased risk of death, according to a study in the June 15 issue of JAMA. This study is being released early online to coincide with its presentation at the AcademyHealth Annual Research Meeting.
"Obesity incidence has stabilized after decades of rapid increases, whereas the prevalence of patients with a body mass index [BMI] greater than 35 increased 39 percent between 2000 and 2005, the prevalence of severe obesity (BMI greater than 40) increased 50 percent, and the prevalence of superobesity (BMI greater than 50) increased 75 percent. Obesity is difficult to treat, and bariatric surgery is the most effective means to induce weight loss for the severely obese. Consequently, obesity surgery rates rapidly increased in tandem," according to background information in the article. "To date, no study to our knowledge has examined the long-term survival of high-risk patients who underwent bariatric surgery."
Matthew L. Maciejewski, Ph.D., of the Durham VA Medical Center, Durham, N.C., and colleagues conducted a study to determine whether bariatric surgery is associated with reduced mortality among predominantly older male high-risk patients at Veterans Affairs medical centers. Mortality was examined for 850 veterans who had bariatric surgery in January 2000 to December 2006 (average age 49.5 years; average BMI, 47.4) and 41,244 nonsurgical controls (average age 54.7 years; average BMI 42.0) from the same 12 Veteran Integrated Service Networks; the follow-up was through December 2008.
Eleven of 850 surgical case patients (1.29 percent) died within 30 days of surgery. The surgical case patients had lower crude mortality rates than the nonsurgical controls (at 1 year, 1.5 percent vs. 2.2 percent; at 2 years, 2.2 percent vs. 4.6 percent; at 6 years, 6.8 percent vs. 15.2 percent ). In unadjusted analysis, bariatric surgery was associated with reduced mortality. However, in further analysis that included 1,694 propensity-matched patients (using a statistical approach to compare patients who appear to be "similar" in many ways, except for one of the matched patients having had the operation), bariatric surgery was not significantly associated with reduced mortality.
"Our results highlight the importance of statistical adjustment and careful selection of surgical and nonsurgical cohorts, particularly during evaluation of bariatric surgery according to administrative data. Previous studies claiming a survival benefit for bariatric surgery had limited clinical information to conduct detailed risk adjustment or matching. The survival differences between the bariatric surgery and control groups were modest in most previous studies, so the beneficial effects of surgery may have been attenuated if adjustment for confounders had been possible. We demonstrated that risk adjustment with regression analysis resulted in a significant association of surgery and survival that was reduced when equivalence in baseline characteristics improved via propensity matching in this high-risk patient group," the authors write.
The researchers add that even though bariatric surgery is not associated with reduced mortality among older male patients, many patients may still choose to undergo bariatric surgery, given the strong evidence for significant reductions in body weight and co-existing illnesses and improved quality of life.
###
(JAMA. 2011;305[23]2419-2426. Available pre-embargo to the media at www.jamamedia.org)
Editor's Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
Please Note: For this study, there will be multimedia content available, including the JAMA Report video, embedded and downloadable video, audio files, text, documents, and related links. This content will be available at 11 a.m. CT Sunday, June 12 at this link.
END
Among Medicare patients with heart attack in 4 California counties, diversion of ambulance traffic by the nearest emergency department for 12 hours or more was associated with an increased risk of death for up to one year, according to a study in the June 15 issue of JAMA. This study is being released early online to coincide with its presentation at the AcademyHealth Annual Research Meeting.
Recent reports have described the state of emergency departments (EDs) in the United States as reaching a breaking point, with the ED system experiencing increased utilization but ...
It sounds like something out of a comic book or a science fiction movie – a living laser – but that is exactly what two investigators at the Wellman Center for Photomedicine at Massachusetts General Hospital have developed. In a report that will appear in the journal Nature Photonics and is receiving advance online release, Wellman researchers Malte Gather, PhD, and Seok Hyun Yun, PhD, describe how a single cell genetically engineered to express green fluorescent protein (GFP) can be used to amplify the light particles called photons into nanosecond-long pulses of laser ...
The GSOS 2 has come to a close and the competition turned out to be a great success, producing a number of winners.
The GSOS 2 Final played out from the 27th of May to the 6th of June, 2011. A guaranteed Prize Pool was up for grabs with the Prize Pool starting at $290,000. The first place winner was guaranteed $100,000 as their minimum prize. The tournament took place on ThunderStruck 2, which is an interactive, prize-collecting 5-Reel Video Slot game based on a Ways to Win base.
The first place winner of the competition (alias: herowoman) walked away with a massive ...
A dramatically better computer tool for finding the genetic missteps that fuel cancer has been developed by St. Jude Children's Research Hospital – Washington University Pediatric Cancer Genome Project investigators. Researchers are using the new algorithm to help identify the chromosomal rearrangements and DNA insertions or deletions unique to cancer.
The new computational method is known as CREST, short for Clipping Reveals Structure. Using CREST, researchers identified 89 new structural differences in the cancer genomes of five St. Jude patients with a subtype of acute ...
A new study published in the journal Clinical & Experimental Allergy reveals that keeping a dog or cat in the home does not increase children's risk of becoming allergic to the pets.
Parents of young children frequently want to know whether keeping a dog or cat in their home will increase the risk of their children becoming allergic to their pets.
Led by Ganesa Wegienka, MS, PhD, of the Department of Public Health Sciences, Henry Ford Hospital, researchers followed a group of children from birth until they reached adulthood. Periodic contact was made with the parents ...
For the first time, scientists have used large-scale DNA sequencing data to investigate a long-standing evolutionary assumption: DNA mutation rates are influenced by a set of species-specific life-history traits. These traits include metabolic rate and the interval of time between an individual's birth and the birth of its offspring, known as generation time. The team of researchers led by Kateryna Makova, a Penn State University associate professor of biology, and first author Melissa Wilson Sayres, a graduate student, used whole-genome sequence data to test life-history ...
Golden Riviera Online Casino releases two new exciting games at the casino. These games are both Video Slots, which offer players the opportunity to win grand prizes.
Power Spins - Sonic 7s
Power Spins - Sonic 7s is an exciting new take on Classical Slot games. This Video Slot has a Classic Slot Theme and offers players a wealth of rewards across 5 Reels. With 9 Paylines, Wilds, Scatters and Power Spins , players can enjoy classic symbols within a retro-look-and-feel game. The PowerSpins feature offers players the opportunity to win up to 8 times Multipliers on wins ...
A new study has determined predictors that can better identify patients who will benefit from a potentially toxic second course of treatment, which offers a small but real chance of cure in select patients with head and neck cancer. Published early online in Cancer, a peer-reviewed journal of the American Cancer Society, the findings could help guide treatment decisions for head and neck cancer patients.
Radiation is often used to treat patients with head and neck cancer. If their cancer reappears, they have limited treatment choices: chemotherapy is not curative, and ...
Crazy Vegas Online Casino in conjunction with the leaders in online gaming, Microgaming have melted 2 new Video Slot games onto their trays.
Sterling Silver 3D Video Slot
Sterling Silver 3D Video slot is the first of its kind to hit the online casino world. It has brought online gaming visually into a new dimension. Sterling Silver 3D is a 5-reel, 25-payline video slot game with Free Spin bonuses and Stacked Wild Multipliers of up to 10x the pay all whilst being viewed in 3D. Inclusive is the Sterling Silver Gamble feature which lets a player double their winnings ...
Hamilton, ON (June 13, 2011) - Proposals recommending routine screening of all children for autism gets a thumbs down from researchers at McMaster University.
In a study in the online edition of the journal Pediatrics, the researchers say there is "not enough sound evidence to support the implementation of a routine population-based screening program for autism."
Not only are there no good screening tools or effective treatments but there is no evidence yet that routine screening does more good than harm, said Dr. Jan Willem Gorter, a researcher in McMaster's CanChild ...
