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July 10, 2006

Scoring Weight Loss Surgery Risks

Gastric_bypass_scoring_system Duke University researchers have developed a new scoring system that they believe can help guide patient decisions regarding gastric bypass surgery.

The five-point scale includes factors that may increase the risk someone will die following the procedure.

The scale was based on a study of gastric bypass outcomes collected from 2,075 patients who had the procedure at Virginia Commonwealth University between 1995 and 2004. Thirty-one patients died within three months of the operation, for a mortality rate of 1.5 percent. The analysis linked a higher risk of death to:

  • A body mass index over 50. (Normal BMI is 18.5-25)
  • Gender. The authors note men are at higher risk for a host of medical problems including high blood pressure, diabetes, and metabolic disorder, which could impact survival rates
  • High blood pressure
  • Risk factors for a pulmonary embolism (blood clot to the lungs)
  • Advanced age. People over age 45 are known to have a higher mortality rate following the surgery

Each factor in the scale is worth one point. Three deaths were noted among the 957 patients scoring between 0-1, for a mortality rate of 0.31 percent. No deaths were recorded among the 356 scoring 0. Among the 999 patients scoring between 2-3, there were 19 deaths, for a mortality rate of 1.91 percent. Among the 119 patients scoring between four and five, there were nine deaths, for a mortality rate of 7.56 percent.

The take home message, note the researchers, is waiting to having gastric bypass surgery may not be a good idea. "Many people see gastric bypass surgery as an option to use only when all other approaches to weight loss have failed," says study author Eric DeMaria, M.D. "However, our system shows that this strategy may need to be reconsidered. If patients put off surgery while they attempt other therapies that ultimately don't work, over time, they risk moving into a higher-risk category as they gain more weight, get older, or develop hypertension. In these cases, delays can make surgery even riskier."

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