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Outcomes of bariatric surgery in geriatric patients ≥ 65 years: single institution study

  • Mohit BhandariEmail author
  • Winni Mathur
  • Mathias Fobi
  • Susmit Kosta
Original Contributions

Abstract

Background

Obesity is an epidemic with an increasing incidence in geriatric individuals also. The aim of the present study is to determine the outcomes in geriatric patients ≥ 65 years, who underwent Bariatric Surgery.

Material and Methods

A retrospective review was performed of prospectively collected data on geriatric patients (age 65 to 80 years) who had undergone bariatric surgery at a single institution from Jan. 2010 to Dec. 2013. A cohort of adult patients (age 17 to 64 years) were matched for comparative evaluation who also underwent bariatric surgery in the same period. The data analyzed included gender, co-morbidities, weight (loss), complications, and resolution of co-morbidities.

Results

184 (7.3%) patients 65 years and older were identified out of 2508 patients who had bariatric surgery between January 2010 and December 2013. These were compared with 184 patients matched for types of surgery. Out of 184 patients in each group, 53 (28.8%) had undergone Roux-en-Y gastric bypass, 39 (21.2%) one anastomosis gastric bypass, and 92 (50%) sleeve gastrectomy. The average age was 68.7 years and 49.85 years in the geriatric and adult groups respectively. Average preoperative weight and BMI were 106.71 kg and117.69 kg and 42.59 kg/m2 and 43.08 kg/m2 in the geriatric and adult groups respectively. The co-morbid conditions were significantly more in the geriatric group. The weight (loss), nutrient deficiencies, and resolution of co-morbid conditions were similar in both groups. There were three major complications in the adult group and two in the geriatric group. One mortality was documented in the adult group from pulmonary embolus.

Conclusion

The outcomes of bariatric surgery in geriatric patients in this study were similar to that in adults. Our study confirms the findings of previous published studies that bariatric surgery could be a safe and effective treatment option in a selected geriatric population.

Keywords

Bariatric metabolic surgery Obesity Weight loss Co-morbidities Geriatric patients 

Notes

Compliance with Ethical Standards

Conflict of Interest

All the authors included in the study have no related conflict of interest. Dr. Mohit Bhandari is a consultant with Johnson and Johnson, Medtronic, Intutive Surgical, Stryker, Karl Storz, Bariatric Solution and Apollo Endo-surgery, none of which had any relationship to this study. Dr. Mathias Fobi is the founding President of Bariatec Corporation and owns shares in the company. This had no relationship with the study. Dr Winni Mathur has no conflict of interest. Dr Susmit Kosta has no conflict of interest. The data collection was done independently by the authors.

Statement of Informed Consent

For this type of study, formal consent was not required of the patient however preoperatively, all patients provided written informed consent for their operation and to have de-identified data analyzed. The institutional review board approved this study.

Statement of Human and Animal Rights

All procedures performed in studies involving human participants were in accordance with the standards of the institution and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

References

  1. 1.
    Mathus-Vliegen EM. Obesity and the elderly. J Clin Gastroenterol. 2012;46:533–44.CrossRefPubMedGoogle Scholar
  2. 2.
    United Nations, Department of Economic and Social Affairs, Population Division World Population Ageing. 2013. Available online: http://www.un.org/en/development/desa/population/publications/pdf/ageing/WorldPopulationAgeing2013.pdf. Accessed 15 Feb 2016
  3. 3.
    Johnson MA, Bales CW. Is there a best body mass index for older adults? Moving closer to evidence-based recommendations regarding “overweight”, health, and mortality. J Nutr Gerontol Geriatr. 2014;33(1):1–9.CrossRefPubMedGoogle Scholar
  4. 4.
    Dey DK, Lissner L. Obesity in 70-year-old subjects as a risk factor for 15-year coronary heart disease incidence. Obes Res. 2003;11(7):817–27.CrossRefPubMedGoogle Scholar
  5. 5.
    Porter Starr KN, McDonald SR, Weidner JA, et al. Challenges in the management of geriatric obesity in high risk populations. Nutrients. 2016;8(5):262.CrossRefGoogle Scholar
  6. 6.
    Flegal KM, Kit BK, Graubard BI. Overweight, obesity, and all-cause mortality-reply. JAMA. 2013;309(16):1681–2.CrossRefPubMedGoogle Scholar
  7. 7.
    Macgregor AM, Rand CS. Gastric surgery in morbid obesity: outcome in patients aged 55 years and over. Arch Surg. 1993;128:1153–7.CrossRefPubMedGoogle Scholar
  8. 8.
    Murr MM, Siadati MR, Sarr MG. Results of bariatric surgery for morbid obesity in patients older than 50 years. Obes Surg. 1995;5(4):399–402.CrossRefPubMedGoogle Scholar
  9. 9.
    Printen KJ, Mason EE. Gastric bypass for morbid obesity in patients more than fifty years of age. Surg Gynecol Obstet. 1977;144(2):192–4.PubMedGoogle Scholar
  10. 10.
    Livingston EH, Huerta S, Arthur D, et al. Male gender is a predictor of morbidity and age a predictor of mortality for patients undergoing gastric bypass surgery. Ann Surg. 2002;236(5):576–82.CrossRefPubMedGoogle Scholar
  11. 11.
    Bales CW, Buhr G. Is obesity bad for older persons? A systematic review of the pros and cons of weight reduction in later life. J Am Med Dir Assoc. 2008;9(5):302–12.CrossRefPubMedGoogle Scholar
  12. 12.
    Health Implications of Obesity. National institutes of health consensus development conference statement panel. Ann Intern Med. 1985;103:1073–7.CrossRefGoogle Scholar
  13. 13.
    Gebhart A, Young MT, Nguyen NT. Bariatric surgery in the elderly: 2009–2013. SurgObesRelat Dis. 2015;11(2):393–8.Google Scholar
  14. 14.
    Esteban JV, Wilson SE, Ninh T. Outcomes of bariatric surgery in the elderly. Am Surg. 2006;72(10):865.Google Scholar
  15. 15.
    Sugerman HJ, DeMaria EJ, Kellum JM, et al. Effects of bariatric surgery in older patients. Ann Surg. 2004;240(2):243–7.CrossRefPubMedGoogle Scholar
  16. 16.
    Keren D, Matter I, Rainis T. Sleeve gastrectomy in different age groups: a comparative study of 5-year outcomes.Google Scholar
  17. 17.
    Giordano S, Victorzon M. Laparoscopic Roux-en-Y gastric bypass is effective and safe in over 55-year-old patients: a comparative analysis. World J Surg. 2014;38(5):1121–6.CrossRefPubMedGoogle Scholar
  18. 18.
    Robert M, Pasquer A, Espalieu P, et al. Gastric bypass for obesity in the elderly: is it as appropriate as for young and middle-aged populations? Obes Surg. 2014;24(10):1662–9.CrossRefPubMedGoogle Scholar
  19. 19.
    Ritz P, Topart P, Benchetrit S, Tuyeras G, Lepage B, Mouiel J, Becouarn G, Pattou F, Chevallier JM. Benefits and risks of bariatric surgery in patients aged more than 60 years. Surg Obes Relat Dis. 2014.Google Scholar
  20. 20.
    Abbas M, Cumella L, Zhang Y, et al. Outcomes of laparoscopic sleeve gastrectomy and Roux-en-Y gastric bypass in patients older than 60. Obes Surg. 2015;25(12):2251–6.CrossRefPubMedGoogle Scholar
  21. 21.
    Van Rutte PW, Smulders JF, de Zoete JP, et al. Sleeve gastrectomy in older obese patients. Surg Endosc. 2013;27(6):2014–9.CrossRefPubMedGoogle Scholar
  22. 22.
    Wittgrove AC, Martinez T. Laparoscopic gastric bypass in patients 60 years and older: early postoperative morbidity and resolution of comorbidities. Obes Surg. 2009;19:1472–6.CrossRefPubMedGoogle Scholar
  23. 23.
    Lynch J, Belgaumkar A. Bariatric surgery is effective and safe in patients over 55: a systematic review and meta-analysis. Obes Surg. 2012;22(9):1507–16.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Mohak Bariatrics and RoboticsMohak Hi-Tech Specialty HospitalIndoreIndia
  2. 2.Sri Aurbindo Medical College and PG InstituteIndoreIndia

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