Abstract:
BACKGROUND:Understanding predictors of mortality in bariatric surgery enables surgeons to use these factors for analysis of risk-adjusted mortality and aids in the surgical decision making and informed consent process. OBJECTIVES:To evaluate the effect of patient characteristics (age, gender, race, and payer type), preoperative comorbidities, and operative technique (laparoscopic versus open, gastric bypass versus gastric band) on mortality in patients who underwent bariatric operations. METHODS:Using the National Inpatient Sample database, clinical data of patients with morbid obesity who underwent bariatric surgery from 2006 to 2008 were examined. Multivariate logistic regression analyses were performed to identify independent predictors of in-hospital mortality. RESULTS:A total 304,515 patients underwent bariatric surgery over the 3-year period. The majority of patients were female (80%) and Caucasian (74%). Their mean age was 44 years and 31.6% were >50 years old. The most common payer type was private (73.5%). Laparoscopic approach was utilized in 86.2% of cases. The overall in-hospital mortality was 0.12%. Using multivariate regression analysis, male gender (adjusted odds ratio [AOR], 1.7), age >50 years (AOR, 3.8), congestive heart failure (AOR, 9.5), peripheral vascular disease (AOR, 7.4), chronic renal failure (AOR, 2.7), open procedure (AOR, 5.5), and gastric bypass operation (AOR, 1.6) were factors associated with greater mortality. Ethnicity, hypertension, diabetes, liver disease, chronic lung disease, sleep apnea, alcohol abuse, and payer type had no association with mortality in this study. CONCLUSION:Modifiable risk factors predictive of mortality include open surgery and gastric bypass procedure; nonmodifiable risk factors include older age, male gender, and a history of congestive heart failure, peripheral vascular disease, and chronic renal failure. Surgeons should consider these factors in selection of patients to undergo bariatric operations, providing informed consent, and selection of the procedural type.
journal_name
Surgeryjournal_title
Surgeryauthors
Nguyen NT,Masoomi H,Laugenour K,Sanaiha Y,Reavis KM,Mills SD,Stamos MJdoi
10.1016/j.surg.2011.05.020subject
Has Abstractpub_date
2011-08-01 00:00:00pages
347-51issue
2eissn
0039-6060issn
1532-7361pii
S0039-6060(11)00220-0journal_volume
150pub_type
杂志文章相关文献
SURGERY文献大全abstract::Two patients with hepatorenal syndrome were treated by insertion of a peritoneovenous shunt. The renal deficit was corrected rapidly in both cases. A 62-year-old woman with a slow onset syndrome with urine output of 100 to 150 ml/day and urinary sodium excretion of 1 mEq/day responded with large volume urinary output ...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1977-09-01 00:00:00
abstract:BACKGROUND:Previous evaluations of the oncologic efficacy of minimally invasive approaches to total gastrectomy in gastric adenocarcinoma have been limited by sample size and duration of follow-up. METHODS:We queried the National Cancer Database to identify patients undergoing robotic and laparoscopic or open total ga...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/j.surg.2019.05.041
更新日期:2019-10-01 00:00:00
abstract::Of 100 patients subjected to pylorus-preserving gastrectomy for surgical treatment of gastric ulcer, 60 were available for follow-up for periods of from one to 9 years. Questionnaires and personal interviews of these 60 and additional laboratory examinations of 40 of them showed results tending to favor the procedure ...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1975-01-01 00:00:00
abstract::Ectopically placed parathyroid adenomas have been described in many locations. This article documents two patients in whom the adenoma was present in the lateral triangle of the neck, outside of the carotid sheath, and lateral to the jugular vein. ...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1987-01-01 00:00:00
abstract::Chronic granulomatous disease (CGD) is a disorder of polymorphonuclear leukocytes that can cause multiple recurrent hepatic abscesses in 40% of those patients with the disorder. The mortality rate from this complication of CGD is estimated at 27%. Treatment has consisted of extensive surgical debridement and drainage ...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1986-05-01 00:00:00
abstract::The diagnosis of multiple endocrine neoplasia (MEN) in patients with presumed hyperparathyroidism has important ramifications for patient management especially since as many as 20% of patients with hyperparathyroidism may have associated MEN. Gut hormone levels were measured before and after surgery in 28 patients who...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1985-12-01 00:00:00
abstract::During a 3-year period (1984 through 1987), 40 patients with smoke inhalation, cutaneous burns, or a combination of both injuries were studied. Injuries were assigned to the three categories on the basis of bronchoscopic findings and clinical history. Eleven patients had simultaneously sustained a common smoke-inhalat...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1987-08-01 00:00:00
abstract::The unexpected finding of hyperamylasemia in a patient with isolated head injury prompted a study of amylase levels in patients with various degrees of cranial trauma. None of seven patients with isolated maxillofacial trauma had hyperamylasemia. This group was studied to discount injury to salivary glands as a source...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1983-08-01 00:00:00
abstract:BACKGROUND:The objectives of the present study are to determine the long-term changes in glucose tolerance function after pancreaticoduodenectomy and to compare the effects of pancreaticojejunostomy (PJ) and pancreaticogastrostomy (PG). Patients and methods The present study consisted of 51 patients who received a panc...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/j.surg.2004.01.006
更新日期:2004-09-01 00:00:00
abstract:BACKGROUND:Differentiation between parathyroid hyperplasia and adenoma is difficult and based on the surgeon's skill. Microarrays and other sophisticated research tools generate information about differential gene expression in various tissues. Exploration of genes that express differentially in 1 tissue will enable id...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1067/msy.2002.128614
更新日期:2002-12-01 00:00:00
abstract::Accuracy and clinical applications of noninvasive imaging of the extracranial carotid arteries were compared using pulsed Doppler and real-time B-mode ultrasonography. During the period December, 1977, to February, 1979, 530 ultrasonograms (265 patients) were performed. Angiographic correlations were available in 90 p...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1980-03-01 00:00:00
abstract:BACKGROUND:Several studies have reported that the triangulating stapling method decreases the incidence of anastomotic stricture after esophagectomy, but no randomized, controlled trial has confirmed the efficacy of the triangulating stapling method for cervical esophagogastrostomy. We compared triangulating stapling a...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/j.surg.2017.01.013
更新日期:2017-07-01 00:00:00
abstract:BACKGROUND:The intestinal epithelial tight junction restricts the paracellular permeation of ions and nonelectrolytes. We hypothesized that this function could be altered or disrupted during cellular adenosine triphosphate (ATP) depletion (chemical hypoxia). METHODS:T84 monolayers grown on permeable supports were stud...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1994-08-01 00:00:00
abstract::Surgical trauma induces immunosuppression that may adversely influence survival. This study examined the effect of laparotomy on two different macrophage populations, peritoneal macrophages (PM phi) and Kupffer cells. Female, 6- to 8-week old, CFW/C3H-HeN mice (n = 160) were randomly allocated to one of three study gr...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1992-06-01 00:00:00
abstract::From 1979 to 1990, 33 children required operative treatment for pancreatitis. Causes included ductal abnormalities (12 children), trauma (10 children), idiopathic (four children), gallstones (three children), drug-induced (three children), and tumor (one child). This study reviews the characteristics and outcome of th...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1991-10-01 00:00:00
abstract::Dogs treated with 15 cm H2O positive end-expiratory pressure (PEEP) invariably show a decrease in cardiac output (CO). Plasma that is obtained from PEEP-treated dogs and applied to an isometrically contracting rat papillary muscle results in a significant depression of the peak developed tension. The present study eva...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1982-03-01 00:00:00
abstract:BACKGROUND:The efficacy of octreotide in the regulation of endocrine tumor secretion and symptomatology has been well documented. Its effects on neuroendocrine tumor generation and cell proliferation are less well understood. The purpose of this study was to determine if blockade of somatostatin receptors by octreotide...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1992-12-01 00:00:00
abstract::Thromboxane (Tx) inhibition prevents pulmonary leukostasis after acid aspiration. This observation prompted study of polymorphonuclear leukocyte (PMN) accumulations and products of cyclooxygenase. Experiments were conducted with a skin abrasion preparation. Five groups of six rabbits were pretreated intravenously with...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1986-01-01 00:00:00
abstract:BACKGROUND:There is currently little information regarding the impact of procedure volume on outcomes after open inguinal hernia repair in the United States. Our hypothesis was that increasing procedure volume is associated with lesser rates of reoperation and resource use. METHODS:The database of the Statewide Planni...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/j.surg.2015.03.058
更新日期:2015-09-01 00:00:00
abstract::During the recent 5 2/3 years, hepatic resection was performed on 118 patients with hepatocellular carcinoma. Ages ranged from 17 to 78 years with an average of 57 years. There were 101 males and 17 females. Underlying cirrhosis of the liver was found in 101 cases, and chronic hepatitis was found in 16 cases. Before s...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1986-06-01 00:00:00
abstract::The efficacy of systemic interleukin-2 (IL-2) immunotherapy is dependent on a competent host immune response. This study demonstrated that protein-calorie malnutrition (PCM) inhibited the generation of an antitumor response to IL-2. A/J mice received an isocaloric diet of 2.5% or 24% casein 8 weeks before inoculation ...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1990-08-01 00:00:00
abstract::Severe abdominal pain was the major indication for operation in 85 patients with chronic pancreatitis. Preoperative endoscopic retrograde cholangiopancreatography (50 patients) or intraoperative pancreatic ductograms (44 patients) demonstrated dilated or obstructed major pancreatic ducts in 50 patients (59%), nonvisua...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1984-10-01 00:00:00
abstract:BACKGROUND:Donor characteristics and graft quality were recently reported to play an important role in the recurrence of hepatocellular carcinoma after liver transplantation. Our aim was to establish a prognostic model by using both donor and recipient variables. METHODS:Data of 1,010 adult patients (training/validati...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/j.surg.2018.01.022
更新日期:2018-04-27 00:00:00
abstract:BACKGROUND:We analyzed the demographics of high-volume surgeons (HVS) for endocrine operations. METHODS:We characterized HVS by region, specialty, gender, teaching-affiliation, American Association of Endocrine Surgeons (AAES) membership, and decade they entered practice. Providers were general surgeons (GS) and otola...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/j.surg.2015.08.024
更新日期:2016-01-01 00:00:00
abstract:BACKGROUND:Activated nuclear factor-kappaB (NF-kappaB) is associated reportedly with the pathogenesis of numerous malignancies. This study investigated whether a common insertion (ins)/deletion (del) polymorphism (-94 ins/del ATTG) in the NFKB1 promoter is associated with susceptibility to gastric cancer and its tumor ...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/j.surg.2008.11.001
更新日期:2009-03-01 00:00:00
abstract::This study evaluated the mixed leukocyte culture (MLC) technique to quantitate differences in kidney allograft survival between unrelated animals. Each of five beagles received two heterotopic kidney allografts, one from a mongrel dog showing high MLC stimulation and one from a second mongrel dog showing a low MLC sti...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1975-07-01 00:00:00
abstract:BACKGROUND:Despite successful revascularization of ischemic extremities, multiorgan dysfunction syndrome develops in some patients. Mechanisms responsible for this are not known; however, the gastrointestinal tract has been implicated as a possible mediator. Our objective was to demonstrate increased intestinal mucosal...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/s0039-6060(96)80076-6
更新日期:1996-09-01 00:00:00
abstract::The central venous dialysis catheter has gained wide acceptance for short-term hemodialysis with the realization of the need to spare peripheral extremity vessels for the creation of more durable internal arteriovenous fistulas. The Hemocath (Quinton Instrument Co., Seattle, Wash.), a soft, silicone rubber, double-lum...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1987-11-01 00:00:00
abstract::A 2-year experience with a computerized in vitro assay of leukocyte adherence inhibition (LAI) indicated that patients with cancer of either the colorectum, stomach, pancreas, breast, or lung expressed antitumor immunity to an organ-type specific neoantigen. About 1% of the 1,299 control subjects with benign or malign...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1980-04-01 00:00:00
abstract:BACKGROUND:It is well recognized that hypoxia/reoxygenation and exposure to inflammatory mediators such as cytokines and neutrophils alter the barrier function of the vascular endothelium. The experiments we conducted tested whether hypoxia alone could produce changes in permeability and whether a prolonged period of h...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1998-09-01 00:00:00