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Sex-Specific Differences in Mortality of Patients with a History of Bariatric Surgery: a Nation-Wide Population-Based Study

H. Beiglböck, E. Mörth, B. Reichardt, T. Stamm, B. Itariu, J. Harreiter, M. Hufgard-Leitner, P. Fellinger, J. Eichelter, G. Prager, A. Kautzky, A. Kautzky-Willer, P. Wolf, and M. Krebs

Abstract

Bariatric surgery reduces mortality in patients with severe obesity and is predominantly performed in women. Therefore, an analysis of sex-specific differences after bariatric surgery in a population-based dataset from Austria was performed. The focus was on deceased patients after bariatric surgery. The Austrian health insurance funds cover about 98% of the Austrian population. Medical health claims data of all Austrians who underwent bariatric surgery from 01/2010 to 12/2018 were analyzed. In total, 19,901 patients with 107,806 observed years postoperative were eligible for this analysis. Comorbidities based on International Classification of Diseases (ICD)-codes and drug intake documented by Anatomical Therapeutical Chemical (ATC)-codes were analyzed in patients deceased and grouped according to clinically relevant obesity-associated comorbidities: diabetes mellitus (DM), cardiovascular disease (CV), psychiatric disorder (PSY), and malignancy (M). In total, 367 deaths were observed (1.8%) within the observation period from 01/2010 to 04/2020. The overall mortality rate was 0.34% per year of observation and significantly higher in men compared to women (0.64 vs. 0.24%; p < 0.001(Chi-squared)). Moreover, the 30-day mortality was 0.19% and sixfold higher in men compared to women (0.48 vs. 0.08%; p < 0.001). CV (82%) and PSY (55%) were the most common comorbidities in deceased patients with no sex- specific differences. Diabetes (38%) was more common in men (43 vs. 33%; p = 0.034), whereas malignant diseases (36%) were more frequent in women (30 vs. 41%; p = 0.025). After bariatric surgery, short-term mortality as well as long-term mortality was higher in men compared to women. In deceased patients, diabetes was more common in men, whereas malignant diseases were more common in women.

H. Beiglböck, E. Mörth, B. Reichardt, T. Stamm, B. Itariu, J. Harreiter, M. Hufgard-Leitner, P. Fellinger, J. Eichelter, G. Prager, A. Kautzky, A. Kautzky-Willer, P. Wolf, and M. Krebs, "Sex-Specific Differences in Mortality of Patients with a History of Bariatric Surgery: a Nation-Wide Population-Based Study," Obesity Surgery, 2021. doi:10.1007/s11695-021-05763-6
[BibTeX]

Bariatric surgery reduces mortality in patients with severe obesity and is predominantly performed in women. Therefore, an analysis of sex-specific differences after bariatric surgery in a population-based dataset from Austria was performed. The focus was on deceased patients after bariatric surgery. The Austrian health insurance funds cover about 98% of the Austrian population. Medical health claims data of all Austrians who underwent bariatric surgery from 01/2010 to 12/2018 were analyzed. In total, 19,901 patients with 107,806 observed years postoperative were eligible for this analysis. Comorbidities based on International Classification of Diseases (ICD)-codes and drug intake documented by Anatomical Therapeutical Chemical (ATC)-codes were analyzed in patients deceased and grouped according to clinically relevant obesity-associated comorbidities: diabetes mellitus (DM), cardiovascular disease (CV), psychiatric disorder (PSY), and malignancy (M). In total, 367 deaths were observed (1.8%) within the observation period from 01/2010 to 04/2020. The overall mortality rate was 0.34% per year of observation and significantly higher in men compared to women (0.64 vs. 0.24%; p < 0.001(Chi-squared)). Moreover, the 30-day mortality was 0.19% and sixfold higher in men compared to women (0.48 vs. 0.08%; p < 0.001). CV (82%) and PSY (55%) were the most common comorbidities in deceased patients with no sex- specific differences. Diabetes (38%) was more common in men (43 vs. 33%; p = 0.034), whereas malignant diseases (36%) were more frequent in women (30 vs. 41%; p = 0.025). After bariatric surgery, short-term mortality as well as long-term mortality was higher in men compared to women. In deceased patients, diabetes was more common in men, whereas malignant diseases were more common in women.
@article{Beiglboeck2021,
doi = {10.1007/s11695-021-05763-6},
year = {2021},
month = nov,
publisher = {Springer Science and Business Media {LLC}},
author = {Hannes Beiglb\"{o}ck and Eric M\"{o}rth and Berthold Reichardt and Tanja Stamm and Bianca Itariu and J\"{u}rgen Harreiter and Miriam Hufgard-Leitner and Paul Fellinger and Jakob Eichelter and Gerhard Prager and Alexander Kautzky and Alexandra Kautzky-Willer and Peter Wolf and Michael Krebs},
title = {Sex-Specific Differences in Mortality of Patients with a History of Bariatric Surgery: a Nation-Wide Population-Based Study},
journal = {Obesity Surgery},
abstract = {Bariatric surgery reduces mortality in patients with severe obesity and is predominantly performed in women.
Therefore, an analysis of sex-specific differences after bariatric surgery in a population-based dataset from Austria was
performed. The focus was on deceased patients after bariatric surgery.
The Austrian health insurance funds cover about 98% of the Austrian population. Medical health
claims data of all Austrians who underwent bariatric surgery from 01/2010 to 12/2018 were analyzed. In total, 19,901 patients
with 107,806 observed years postoperative were eligible for this analysis. Comorbidities based on International Classification
of Diseases (ICD)-codes and drug intake documented by Anatomical Therapeutical Chemical (ATC)-codes were analyzed
in patients deceased and grouped according to clinically relevant obesity-associated comorbidities: diabetes mellitus (DM),
cardiovascular disease (CV), psychiatric disorder (PSY), and malignancy (M).
In total, 367 deaths were observed (1.8%) within the observation period from 01/2010 to 04/2020. The overall
mortality rate was 0.34% per year of observation and significantly higher in men compared to women (0.64 vs. 0.24%;
p < 0.001(Chi-squared)). Moreover, the 30-day mortality was 0.19% and sixfold higher in men compared to women (0.48
vs. 0.08%; p < 0.001). CV (82%) and PSY (55%) were the most common comorbidities in deceased patients with no sex-
specific differences. Diabetes (38%) was more common in men (43 vs. 33%; p = 0.034), whereas malignant diseases (36%)
were more frequent in women (30 vs. 41%; p = 0.025).
After bariatric surgery, short-term mortality as well as long-term mortality was higher in men compared to
women. In deceased patients, diabetes was more common in men, whereas malignant diseases were more common in women.},
pdf = {pdfs/Beiglboeck2021_Article_Sex-SpecificDifferencesInMorta.pdf},
thumbnails = {images/2021-Moerth-Diabetes-thumb.png},
images = {images/2021-Moerth-Diabetes.png},
keywords = {Bariatric surgery, Sex differences, Mortality, Population-based registry analysis, Comorbidities, Healthcare, research},
}
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