Clinical research studyRisk of Suicide after Long-term Follow-up from Bariatric Surgery
Section snippets
Methods
Data were obtained from the following 2 sources: the Pennsylvania Health Care Cost and Containment Council database,44 to identify patients hospitalized for bariatric surgery, and the Division of Vital Records, Pennsylvania State Department of Health, to determine suicides (as judged by the coroner or medical examiner) and obtain copies of death certificates.
The Pennsylvania Health Care Cost and Containment Council collects data in the state of Pennsylvania, including all hospital discharges
Results
There were 31 total suicides. Mean age of the deceased was 45 years, and they were primarily female (65%, Table 1) and white (94%). Mean time to death was about 3 years after surgery, with 10% occurring in the first year, 29% within the first 2 years, and 68% within 3 years after surgery (Table 2). The distribution of suicides by year of bariatric surgery is shown in Table 3. The incidence of suicide was 6.6 per 10,000 person-years. Men had higher rates of suicide in each age category except
Discussion
We examined all suicides occurring between 1996 and 2006 among postbariatric surgery patients residing in Pennsylvania. There were 31 total suicides in this population, for an overall rate of 13.7 per 10,000 among men and 5.2 per 10,000 among women. It is very likely that suicide deaths were also underestimated because some of the deaths were listed as drug overdose, rather than suicide, on the death certificate. In this case, the suicide rate postbariatric surgery would be even higher than
Acknowledgment
The authors gratefully acknowledge Ms. Monica Love for preparing this manuscript for publication, and Mr. Alhaji Buhari for statistical support.
References (58)
- et al.
Impact of gastric bypass operation on survival: a population-based analysis
J Am Coll Surg
(2004) - et al.
Perioperative risks and safety of surgery for severe obesity
Am J Clin Nutr
(1992) - et al.
Trends in mortality in bariatric surgery: a systematic review and meta-analysis
Surgery
(2007) - et al.
Laparoscopic gastric bypass: risks vs. benefits up to two years following surgery in super-super obese patients
Surgery
(2006) - et al.
Long-term outcome of bariatric surgery: an interim analysis
Mayo Clinic Proc
(2006) - et al.
Risk factors for post-operative mortality in bariatric surgery
J Surg Res
(2005) - et al.
Factors influencing survival following surgical treatment of obesity
Obes Surg
(2005) - et al.
Associations of obesity with psychiatric disorders and suicidal behaviors in a nationally representative sample
J Psychosom Res
(2009) - et al.
Relationship of psychiatric disorders to 6-month outcomes after gastric bypass
Surg Obes Relat Dis
(2008) - et al.
Obesity, unexplained weight loss and suicide: the original Whitehall study
J Affect Disord
(2009)
The prevalence of self-harm behaviors among a sample of gastric surgery candidates
J Psychosom Res
Suicide
Lancet
Clinical management after bariatric surgery: value of a multidisciplinary approach
Mayo Clinic Proc
Surveillance and ascertainment of cardiovascular events : the Cardiovascular Health Study
Ann Epidemiol
Suicides following bariatric surgery for the treatment of obesity
Surg Obes Relat Dis
Does gastric bypass alter alcohol metabolism?
Surg Obes Relat Dis
Benefits to patients choosing preoperative weight loss in gastric bypass surgery: new results of a randomized trial
J Am Coll Surg
No surgical innovation without evaluation: the IDEAL recommendations
Lancet
Screening and interventions for obesity in adults: summary of the evidence for the U.S.Preventive Services Task Force
Ann Intern Med
Gastrointestinal surgery for severe obesity: National Institutes of Health Consensus Development Conference Statement
Am J Clin Nutr
Prevalence of overweight and obesity among US children, adolescents, and adults, 1999-2002
JAMA
Bariatric surgery: a systematic review and meta-analysis
JAMA
Multivariate analysis of risk factors for death following gastric bypass for treatment of morbid obesity
Ann Surg
Perioperative safety in the longitudinal assessment of bariatric surgery
N Engl J Med
Perioperative safety in the longitudinal assessment of bariatric surgery
N Engl J Med
Long-term mortality after gastric bypass surgery
N Engl J Med
Early mortality among Medicare beneficiaries undergoing bariatric surgical procedures
JAMA
Fatal complications of bariatric surgery
Obes Surg
Death rates and causes of death after bariatric surgery for Pennsylvania residents, 1995 to 2004
Arch Surg
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Funding: This publication was made possible by a grant from the National Center for Research Resources (NCRR), a component of the National Institutes of Health (NIH), and NIH Roadmap for Medical Research (KL2 RR024154-05, Dr. Tindle). Its contents are solely the responsibility of the authors and do not necessarily represent the official view of NCRR or NIH. Information on NCRR is available at http://www.ncrr.nih.gov/. Information on Re-engineering the Clinical Research Enterprise can be obtained from http://nihroadmap.nih.gov/clinicalresearch/overview-translational.asp.
Conflict of Interest: There are no conflicts of interest to report.
Author: All authors had access to the data and had a role in writing the manuscript.