Elderly are at greater risk of death after gastric bypass than once thought

• Medicare patients who undergo weight-loss surgery face a considerably higher risk of death than has been reported for other patients in previous studies, with 2 percent dying within 30 days of surgery and almost 5 percent dying within a year, a study of Medicare patients of all ages found.
• The American Society for Bariatric Surgeons and several earlier studies have put the death rate from the surgery at 0.5 percent, or one in 200.
• The paper was one of several published yesterday in the Journal of the American Medical Association that reported sobering results about the safety of weight- loss surgery.
• Another study found patients, whose average age was 42 years old, were twice as likely to end up in the hospital the year after gastric bypass surgery as they were the year before, mostly to be treated for surgical complications.
• Wolfe suggested that the poor outcomes of Medicare patients reflected a much sicker, disabled population at significantly higher risk than the average patient coming for weight-loss surgery.
• But Dr. Dave Flum, lead author of the Medicare study and an associate professor of surgery at University of Washington in Seattle, said the low mortality rates that have been reported in the past for such procedures were from "the best surgeons reporting the best results.
• "It's a high-risk operation, in a high-risk population, and there's nothing wrong with saying that.
• The desire on the part of the surgical community to minimize the risk is not well-advised."
• Concern about the risks does not appear to be discouraging Americans from having bariatric surgery.
• A third paper in JAMA estimated that the number of procedures has multiplied from 13,365 in 1998 to 72,177 by 2002, and was projected to reach 102,794 by 2003.