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September 28, 2011

Survival After Bariatric Surgery Among High-Risk Patients—Reply

Author Affiliations

Letters Section Editor: Jody W. Zylke, MD, Senior Editor.

Author Affiliations: Center for Health Services Research in Primary Care, Durham VA Medical Center, Durham, North Carolina (Dr Maciejewski) (matthew.maciejewski@va.gov); Division of Gastrointestinal and Endocrine Surgery, University of Texas Southwestern Medical Center, Dallas (Dr Livingston); and Group Health Research Institute, Seattle, Washington (Dr Arterburn).

JAMA. 2011;306(12):1323-1324. doi:10.1001/jama.2011.1351

In Reply: We agree with Dr Patterson and colleagues that there should be longer follow-up before making a definitive statement about the survival benefit of bariatric surgery in older male patients. However, the mean follow-up of surgical patients in our study (6.7 years) was similar to follow-up in the Utah study (7.1 years)1 and the average follow-up time (7.2 years) in the meta-analysis of 8 nonrandomized trials2 that found bariatric surgery reduced all-cause mortality. Perhaps a more important difference between that meta-analysis and our own study was the proportion male (26% in pooled meta-analytic sample vs 74% in our sample).