Association of Pre-operative Arthritis with Long-Term Mortality Following Bariatric Surgery

Jaewhan Kim, Joshua Kelley, Sayeed Ikramuddin, Jake Magel, Nathan Richards, Ted Adams

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


Background: Metabolic and bariatric surgery (MBS) is an effective treatment for obesity and may reduce mortality. Several factors are associated with higher mortality following MBS. The purpose of this study was to examine whether pre-operative arthritis was associated with long-term mortality following MBS. Methods: Using a retrospective cohort design, subjects who underwent MBS were identified from the Utah Bariatric Surgery Registry. These subjects were linked to the Utah Population Database. State death records from 1998 through 2021 were used to identify deaths following MBS. ICD-9/10 diagnosis codes were used to identify a pre-operative diagnosis of arthritis and to classify the cause of death. All causes of death, internal cause of death (e.g., diabetes, heart disease), and external cause of death (e.g., suicide) were defined as outcomes. Entropy balancing (EB) was applied to create weights to balance the baseline characteristics of the two groups. Weighted Cox proportional hazards regression was used to evaluate the association of pre-operative arthritis with long-term mortality following MBS. Results: The final sample included 15,112 patients. Among them, 36% had a pre-operative arthritis diagnosis. Average (SD) age was 48(12) years old at surgery, and 75% were female. Patients with pre-operative arthritis had 25% (p < 0.01) and 26% (p < 0.01) higher risk of all cause of death and internal cause of death, respectively, compared to patients without pre-operative arthritis. Conclusion: Individuals with arthritis prior to MBS may have higher hazard of long-term mortality than those without pre-operative arthritis.

Original languageEnglish (US)
Pages (from-to)895-902
Number of pages8
JournalJournal of Gastrointestinal Surgery
Issue number5
StatePublished - May 2023

Bibliographical note

Funding Information:
Jaewhan Kim has received research funding from Utah Department of Health and Intermountain Medical Research and Education Foundation. Ted Adams has received research funding from NIH-NIDDK; Ethicon Endo-Surgery; and Intermountain Medical Research and Education Foundation, Intermountain Healthcare. The other authors declare that they have no conflicts of interest.

Funding Information:
We thank the Utah Clinical and Translational Science Institute (CTSI) (funded by NIH Clinical and Translational Science Awards), the Pedigree and Population Resource, University of Utah Information Technology Services and Biomedical Informatics Core for establishing the Master Subject Index between the Utah Population Database and the University of Utah Health Sciences Center.

Funding Information:
Partial support for all datasets within the Utah Population Database was provided by the University of Utah Huntsman Cancer Institute and the Huntsman Cancer Institute Cancer Center Support grant (grant number P30 CA2014) from the National Cancer Institute.

Publisher Copyright:
© 2023, The Society for Surgery of the Alimentary Tract.


  • Arthritis
  • Bariatric surgery
  • Long-term mortality

PubMed: MeSH publication types

  • Journal Article
  • Research Support, N.I.H., Extramural


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