Preventing Bariatric Surgery Deaths

Implications:  Bariatric surgery is a major operative procedure that caries significant morbidity and mortality risks due to the comorbid diseases seen in this patient population.  This procedure is increasing in frequency as more patients are willing to have it and more surgeons are becoming proficient. The mortality rate is ~ 1 % at 1 year and 6% at 5 years which is greater than the population at large.

Analysis:  The URL for this article is:

http://www.medscape.com/viewarticle/567726?src=mp

http://www.medscape.com/medline/abstract/17938303 

There is an excess of cardiovascular deaths and suicides in patients following bariatric surgery. 

These patients require careful pre-op evaluation (ie cardiac) and optimization and careful post - op monitoring to decrease some of the preventable deaths (ie suicides).

This requires a team approach as the risks to these patients does not end after the perioperative period.

Meticulous attention to surgical detail, patient selection for the individual procedure (bypass vs lap band, open vs laparoscopic, etc), perioperative glycemic and BP control, PE prophylaxis, and dietary and emotional counseling are all important components of this procedure.