Abstract
Introduction
Obesity and its associated comorbidities represent a pervasive problem in the United States across all age groups. There are conflicting data regarding the effectiveness and postoperative recovery of bariatric surgery in elderly patients. The aim of this study was to compare outcomes of bariatric surgery across age groups.
Materials and Methods
After obtaining institutional review board approval, patients with morbid obesity who underwent non-revisional laparoscopic Roux-en-Y gastric bypass (LRYGB) and sleeve gastrectomy (LSG) at our institution between 2011 and 2015 were included in this retrospective study. Patients were subdivided into five age groups: < 30, 30–39, 40–49, 50–59, and ≥ 60 years. Patient baseline demographics and comorbidities were collected. Postoperative outcomes including reinterventions/reoperations, 30-day-readmissions, 90-day-mortality, comorbidities’ resolution, and change in BMI (ΔBMI) up to 4 years were recorded and compared. The groups were compared with ANOVA and chi-square tests and multivariable analyses.
Results
LRYGB was performed in 74.7% of the 1026 study patients. Patients ≥ 60 years old demonstrated lower preoperative BMI than patients < 50 years (p < 0.001). Patients 50–59 years old had increased length of stay compared to 30–39 (p = 0.003) and a higher prevalence of all comorbidities was found in older patients (p < 0.001). There was no significant difference in 30-day-readmissions; 90-day-mortality; reoperations; and reinterventions among the study groups. The ΔBMI was higher in younger patients and comorbidity resolution was more likely in younger patients with the exception of obstructive sleep apnea.
Conclusion
Bariatric surgery can be accomplished safely across all age groups with satisfiable postoperative weight loss. However, older age had higher hospital stay and convalescence and lower comorbidity resolution compared to younger patients. Thus, bariatric surgery should be offered earlier in life to allow the patients to reap its benefits.
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Dr. Selzer is a consultant for Cook Biotech and PolyNovo, and has received research support by Bard; however, none of the research in the present report was funded by the above. Dr. Dimitrios Stefanidis has received research support to institution by ExplORer Surgical Inc. and Bard; however, none of the research in the present report was funded by the above. Dr. Dimitrios I. Athanasiadis, Dr. Edward Hernandez, Dr. Sara Monfared, Dr. Natalia Kubicki, Mr. Nehal Ninad, Ms. Amani Karim, and Dr. Ambar Banerjee have no conflicts of interest or financial ties to disclose.
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Athanasiadis, D.I., Hernandez, E., Monfared, S. et al. Bariatric surgery outcomes: is age just a number?. Surg Endosc 35, 3139–3146 (2021). https://doi.org/10.1007/s00464-020-07752-9
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DOI: https://doi.org/10.1007/s00464-020-07752-9