In case anyone was still wondering if gastric bypass increases overall
mortality, there is a new study mentioned below.

Impressive numbers, but with an interesting twist.

Boron

http://www.medscape.com/viewarticle/565374?src=mp
Adams TD, Gress RE, Smith SC, et al
N Engl J Med. 2007; 357: 753-61
Summary

The authors studied long-term mortality in 2 groups (7925 each) of
severely obese persons (body mass index, 44.9): gastric bypass
patients versus a control group of severely obese persons applying for
drivers' licenses. The endpoint was mortality over a mean period of
7.1 years. Death rates were 37.7/10,000 person-years in the surgical
group compared with 57.1/10,000 person-years in the control group, a
reduction of 40% (P < .001). Death rates in the surgical group were
lower for heart disease, diabetes, and cancer but were higher for
accidental deaths and suicide.

"Boron Elgar" > wrote in message
...
> In case anyone was still wondering if gastric bypass increases overall
> mortality, there is a new study mentioned below.
>
> Impressive numbers, but with an interesting twist.
>
> Boron
>
> http://www.medscape.com/viewarticle/565374?src=mp
> Adams TD, Gress RE, Smith SC, et al
> N Engl J Med. 2007; 357: 753-61
> Summary
>
> The authors studied long-term mortality in 2 groups (7925 each) of
> severely obese persons (body mass index, 44.9): gastric bypass
> patients versus a control group of severely obese persons applying for
> drivers' licenses. The endpoint was mortality over a mean period of
> 7.1 years. Death rates were 37.7/10,000 person-years in the surgical
> group compared with 57.1/10,000 person-years in the control group, a
> reduction of 40% (P < .001). Death rates in the surgical group were
> lower for heart disease, diabetes, and cancer but were higher for
> accidental deaths and suicide.

That was an interesting read. But I can only hope that my GB didn't end up
making me more clumsy I was bad enough already without that help. The
suicide right? I have no idea on that one. Homicide I might believe since
those first months when it feels like you are swallowing glass as your
esophagous and stomach heal killing someone sitting in front of you eating a
hamburger fries and a Coke without a problem might be a temptation.

Thanks for the read.

Cindi

Sqwertz > wrote:

>On Wed, 12 Dec 2007 14:30:45 -0500, Boron Elgar wrote:

>> The authors studied long-term mortality in 2 groups (7925 each) of
>> severely obese persons (body mass index, 44.9): gastric bypass
>> patients versus a control group of severely obese persons applying for
>> drivers' licenses.

>Did the DMV do this study? Or are they selling our information
>to third-parties without our consent?

Good point.

>> The endpoint was mortality over a mean period of
>> 7.1 years. Death rates were 37.7/10,000 person-years in the surgical
>> group compared with 57.1/10,000 person-years in the control group, a
>> reduction of 40% (P < .001). Death rates in the surgical group were
>> lower for heart disease, diabetes, and cancer but were higher for
>> accidental deaths and suicide.

>I'd hardly consider license applications a good source of medical
>information. Especially for the question, "Have you ever
>committed suicide"?

If it's based on randomly-selected high-weight people who
appeared at DMV, then there are all sorts of problems with
the DMV dataset. For one thing, it would include people who
don't have health insurance in the first place (which the
bypass group obviously did). It would also include people who
wouldn't qualify for bypass surgery for various negatives reasons
(addicts, alcoholics, those too sick to go through surgery, etc.)
The bypass group has none of these characteristics.

Steve

"Sqwertz" > wrote in message
...
> On Wed, 12 Dec 2007 14:30:45 -0500, Boron Elgar wrote:
>
>> The authors studied long-term mortality in 2 groups (7925 each) of
>> severely obese persons (body mass index, 44.9): gastric bypass
>> patients versus a control group of severely obese persons applying for
>> drivers' licenses.
>
> Did the DMV do this study? Or are they selling our information
> to third-parties without our consent?

Since the DMV has no idea of obesity or BMI of those applying for driver's
licenses it was probably a controlled study group where the participants
gave the researchers permission to access their records.

>
>> The endpoint was mortality over a mean period of
>> 7.1 years. Death rates were 37.7/10,000 person-years in the surgical
>> group compared with 57.1/10,000 person-years in the control group, a
>> reduction of 40% (P < .001). Death rates in the surgical group were
>> lower for heart disease, diabetes, and cancer but were higher for
>> accidental deaths and suicide.
>
> I'd hardly consider license applications a good source of medical
> information. Especially for the question, "Have you ever
> committed suicide"?

Again if it is a controlled group, the researcher would be provided this
information.

>
> Granted, they probably get most of that info from death records
> (which don't mention gastric bypass surgeries).
>

If an autopsy is performed or their death is a result of their gastric
bypass and listed as a contributing cause of death, it would be there. But
as this was perhaps a controlled study group the researcher would be
informed of any deaths and their cause.

Having worked on several studies while I was working for an internist, there
is lots of information that is collected to better understand a patient's
health, lifestule, risk factors, etcetera so it would not be unusual for
some information to be DMV related.

HTH
Cindi

> -sw

Cindi - HappyMamatoThree > wrote:

>"Sqwertz" > wrote in message

>> Did the DMV do this study? Or are they selling our information
>> to third-parties without our consent?

> Since the DMV has no idea of obesity or BMI of those applying for
> driver's licenses it was probably a controlled study group where
> the participants gave the researchers permission to access
> their records.

You may be right about the last part of that, but it seems to
me the DMV has the height and weight on everyone and from that
they can get the BMI.

Steve

Sqwertz > wrote:

>There was no other information provided about the dataset in the
>abstract, but it did imply that it was random without any other
>controls.

The abstract says they matched for age, sex, and body-mass
index. That's all. So the surgery group and the control group
are from two different populations with all sorts of unmatched
factors.

Steve

> BMI is calculated by height and weight. Both of which are
> collected by the DMV apps. And that info is submitted in good
> faith (unverified)
>
>> If an autopsy is performed or their death is a result of their gastric
>> bypass and listed as a contributing cause of death, it would be there.
>> But
>> as this was perhaps a controlled study group the researcher would be
>> informed of any deaths and their cause.
>
> There was no other information provided about the dataset in the
> abstract, but it did imply that it was random without any other
> controls.
>
> -sw

You're right there didn't seem to be any other markers used. However, in
order to know that the participants had a gastric bypass surgery, something
outside the typical information gathering by DMV would have had to be
utilized.

I would really like to see a better write up of the study and how the
dataset was gathered, confirmed, etcetera.

Cindi

Sqwertz > wrote:

>The control set did not have any samples except what was provided
>by their drivers license applications. The proponent set had
>actual medical records (and other care, as the other Steve noted)

In addition to the factors I mentioned earlier, it seems
to me that the researchers also have no way of knowing whether
some individuals in the control set went ahead and had
bypass operations.

And there is the following disclaimer:

From http://www.medscape.com/viewarticle/562298

"The study is limited by the lack of data on cardiovascular risk
and comorbidities in the surgical and control groups."

S.