Bariatric Surgery in the Elderly Patient: Safety and Short-time Outcome. A Case Match Analysis
- 101 Downloads
Indications and outcomes of bariatric surgery in the elderly remain controversial. We aimed to evaluate and compare safety and early outcomes of bariatric procedures in this age group.
We performed a retrospective case-control study of Mayo Clinic bariatric surgery patients from January 1, 2016, to January 31, 2018. Data collection included surgery type, sex, age, body mass index (BMI), and comorbidities (hypertension, diabetes mellitus, hyperlipidemia, and obstructive sleep apnea (OSA)). Patients aged 65 years old or older were matched with controls younger than 65 years by body mass index (BMI). We assessed length of stay (LOS), perioperative and early postoperative outcomes, short-term weight loss, and complications.
We included 150 bariatric patients, with a case-to-control ratio of 1:2. After laparoscopic sleeve gastrectomy, no significant difference was found in LOS between groups (2.4 vs 2.6 days; P = 0.52), 1-month BMI difference (3.35 vs 3.88; P = 0.17), mean nadir excess BMI loss (%EBL) (22.14 vs 23.2; P = 0.75), or complication rate (0% vs 3.3%; P > 0.99). Similarly, the laparoscopic or robotic-assisted Roux-en-Y gastric bypass (RYGB) cohort showed no difference in LOS (2.65 vs 2.54 days; P = 0.68), 1-month BMI difference (4.72 vs 4.53; P = 0.68), %EBL (31.7 vs 26.6; P = 0.13), or complication rate (11.7% vs 5.71%; P = 0.43).
Although the sample size is small to draw definitive conclusions, bariatric surgery in patients 65 years or older seems to be safe, with similar outcomes and complication rates as in younger patients, regardless of procedure performed.
KeywordsBariatric surgery Body mass index Elderly patient Laparoscopic robotic-assisted Roux-en-Y gastric bypass Laparoscopic Roux-en-Y gastric bypass Laparoscopic sleeve gastrectomy
Conception and design of the work: All authors
Drafting the manuscript: Dr. Vinan-Vega
Critical review of the manuscript for important intellectual content: all authors
Manuscript supervision: Dr. Elli
Approval of the version to be published: all authors
We certify that all authors of this manuscript have participated in conceptualizing the research or content of the manuscript, in writing or critically editing the manuscript, and/or in analysis of data presented in the manuscript. Consent to submit has been received from all co-authors.
Compliance with Ethical Standards
Conflict of Interest
The authors declare that they have no conflict of interest.
Statement of Human and Animal Rights
For this type of study, formal consent is not required.
- 1.Ogden CCM, Fryar C, Flegal K. Prevalence of obesity among adults and youth: United States, 2011–2014. NCHS Data Brief. 2015;219:1–8.Google Scholar
- 3.Giordano S, Victorzon M. Bariatric surgery in elderly patients: a systematic review. Clin Interv Aging. 2015;10:1627–35.Google Scholar
- 8.Caceres BA, Moskowitz D, O'Connell T. A review of the safety and efficacy of bariatric surgery in adults over the age of 60: 2002–2013. J Am Assoc Nurse Pract. 2015;27:403–10.Google Scholar
- 17.Hajer AA, Wolff S, Benedix F, et al. Trends in early morbidity and mortality after sleeve gastrectomy in patients over 60 years: retrospective review and data analysis of the German Bariatric Surgery Registry. Obes Surg. 2018;28:1831–7. https://doi.org/10.1007/s11695-018-3110-6.CrossRefGoogle Scholar
- 22.Ritz P, Topart P, Benchetrit S, et al. Benefits and risks of bariatric surgery in patients aged more than 60 years. Surg Obes Relat Dis. 2014; https://doi.org/10.1016/j.soard.2013.12.012.