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Effects of bariatric surgery on mortality in Swedish obese subjects.

Artikel i vetenskaplig tidskrift
Författare Lars Sjöström
Kristina Narbro
C David Sjöström
Kristjan Karason
Bo Larsson
Hans Wedel
Ted Lystig
Marianne Sullivan
Claude Bouchard
Björn Carlsson
Calle Bengtsson
Sven Dahlgren
Anders Gummesson
Peter Jacobson
Jan Karlsson
Anna-Karin Lindroos
Hans Lönroth
Ingmar Näslund
Torsten Olbers
Kaj Stenlöf
Jarl S Torgerson
Göran Agren
Lena M S Carlsson
Publicerad i The New England journal of medicine
Volym 357
Nummer/häfte 8
Sidor 741-52
ISSN 1533-4406
Publiceringsår 2007
Publicerad vid Institutionen för medicin, avdelningen för samhällsmedicin och folkhälsa
Institutionen för kliniska vetenskaper, Avdelningen för anestesiologi och intensivvård
Institutionen för medicin, avdelningen för klinisk prövning och entreprenörskap
Institutionen för medicin, avdelningen för molekylär och klinisk medicin
Institutionen för kliniska vetenskaper
Sidor 741-52
Språk en
Länkar dx.doi.org/10.1056/NEJMoa066254
Ämnesord Bariatric Surgery, Body Mass Index, Cardiovascular Diseases, mortality, Case-Control Studies, Female, Follow-Up Studies, Humans, Male, Middle Aged, Multivariate Analysis, Obesity, mortality, surgery, Risk Factors, Sweden, epidemiology, Weight Loss
Ämneskategorier Endokrinologi

Sammanfattning

BACKGROUND: Obesity is associated with increased mortality. Weight loss improves cardiovascular risk factors, but no prospective interventional studies have reported whether weight loss decreases overall mortality. In fact, many observational studies suggest that weight reduction is associated with increased mortality. METHODS: The prospective, controlled Swedish Obese Subjects study involved 4047 obese subjects. Of these subjects, 2010 underwent bariatric surgery (surgery group) and 2037 received conventional treatment (matched control group). We report on overall mortality during an average of 10.9 years of follow-up. At the time of the analysis (November 1, 2005), vital status was known for all but three subjects (follow-up rate, 99.9%). RESULTS: The average weight change in control subjects was less than +/-2% during the period of up to 15 years during which weights were recorded. Maximum weight losses in the surgical subgroups were observed after 1 to 2 years: gastric bypass, 32%; vertical-banded gastroplasty, 25%; and banding, 20%. After 10 years, the weight losses from baseline were stabilized at 25%, 16%, and 14%, respectively. There were 129 deaths in the control group and 101 deaths in the surgery group. The unadjusted overall hazard ratio was 0.76 in the surgery group (P=0.04), as compared with the control group, and the hazard ratio adjusted for sex, age, and risk factors was 0.71 (P=0.01). The most common causes of death were myocardial infarction (control group, 25 subjects; surgery group, 13 subjects) and cancer (control group, 47; surgery group, 29). CONCLUSIONS: Bariatric surgery for severe obesity is associated with long-term weight loss and decreased overall mortality.

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