Gastric bypass improves survival compared with propensity-matched controls: a cohort study with over 10-year follow-up.

Abstract Background The purpose of this study is to evaluate the long-term survival following gastric bypass using propensity-matched controls. Methods We identified all patients who either received a gastric bypass (GBP) or met criteria to receive a GBP between January 1, 2002 and December 31, 2003. Propensity matching was performed. Long-term, all-cause mortality data were collected and evaluated using Kaplan–Meier curves. Results Four hundred thirty GBP cases and 5,323 controls were identified from the enrollment period. Ultimately, 802 cases and controls (1:1 matching, 93.2% match rate) were identified using propensity matching. Median follow-up was similar between groups. Overall mortality was lower for the GBP group (odds ratio .48, 95% confidence interval .29 to .78). GBP demonstrated significantly increased survival when compared with controls ( P = .002). Similar patterns were noted among diabetics. Conclusion We have demonstrated that gastric bypass provides a clear long-term survival advantage compared with nonsurgical propensity-matched controls.