Men at 'much greater' risk of dying after weight-loss surgery – Nursing Times


‘There was much to be hopeful for in terms of resolutions passed’
STEVE FORD, EDITOR
30 September, 2021 By
Men who undergo bariatric surgery are five times as likely to die within 30 days of the procedure compared to women, researchers have found.
In addition, their long-term mortality is almost three times higher, according to their analysis of national data from Austria spanning 10 years and involving over 19,000 patients.
“The challenge now is to understand potential barriers for men to undergo bariatric surgery”
Hannes Beiglböck
The findings also indicate that men tend to be older and have higher rates of comorbidities such as cardiovascular disease and type 2 diabetes at the time of surgery.
The researchers said this highlighted a pressing need to educate men about the importance of treating obesity earlier, before they developed potentially life-threatening comorbidities.
The findings were presented this week at the annual meeting of the European Association for the Study of Diabetes (EASD).
Study authors noted that bariatric surgery could result in lasting weight loss and lower risks of associated conditions, including cardiovascular disease, hypertension, type 2 diabetes and cancer.
Common procedures could include sleeve gastrectomy, gastric bypass, biliopancreatic diversion, or gastric banding.
They analysed data from Austrian state insurance that covers around 98% of the population – around nine million people.
In total, 19,901 patients who had undergone bariatric surgery between January 2010 and December 2018 were included in the analyses.
Of these, 14,681 were women and 5,220 were men. The average age was 41-42 years. Patients were followed for an average of five years. Between January 2010 and April 2020, less than 2% died.
Nevertheless, overall postoperative mortality rates were almost three times higher among men than women, although deaths were rare in absolute terms.
Specifically, the researchers flagged that 30-day mortality was five-fold higher in men compared to women – 25 deaths versus 12 deaths.
Among those who died, cardiovascular diseases and psychiatric disorders were the most common comorbidities. Type 2 diabetes was more common in men who died and cancers in women.
Lead author Dr Hannes Beiglböck, from the Medical University of Vienna, said: “Surgical procedures are some of the most successful ways to help people with extreme obesity to lose weight, but they can come with complications.”
She said: “Although the absolute risk of dying after bariatric surgery is low, the findings of our large nationwide study highlight a substantially increased mortality risk among men compared to women.
“Women seem more willing to look at surgical weight loss earlier in life, whereas men tend to wait until they have more comorbidities.”
She added: “The challenge now is to understand potential barriers for men to undergo bariatric surgery and further research should be performed to explore if earlier surgical intervention in men could improve mortality outcomes.”
The study authors acknowledged that their findings are observational and that data on body mass index and weight loss were not available for the analysis.
In addition, they could not rule out the possibility that other unmeasured factors, including socioeconomic status, or missing data, like dietary habits, may have affected the results.
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