Bariatric Surgery Outcomes in Patients Aged 65 Years and Older at an American Society for Metabolic and Bariatric Surgery Center of Excellence
Rent the article at a discountRent now
* Final gross prices may vary according to local VAT.Get Access
Although morbid obesity rates in patients ≥65 years of age are increasing, few centers have reported weight loss surgery outcomes in elderly patients, resulting in a paucity of literature on perioperative mortality and morbidity.
A retrospective analysis was performed on 197 consecutive patients ≥65 years old who underwent weight loss surgery from January 2000 to December 2007. Primary data points included 30-day and 1-year mortality rates, length of stay (LOS), percent excess weight loss (EWL), change in daily medication use, and quality of life (QOL).
The average patient's age was 67.3 years with 72.1% being female. Average preoperative weight and BMI were 131.9 kg and 48.1 kg/m2, respectively. Average preoperative daily medication use was 8.04 ± 3.67. Procedure types included Roux-en-Y gastric bypass (79.3%), adjustable gastric banding (17.2%), and vertical sleeve gastrectomy (3%). Ninety-seven percent of procedures were performed laparoscopically. Average LOS was 2.0 ± 2.1 days. Average weight, BMI, and daily medication use were significantly reduced at 6 months and 1 year (p < 0.001), with patients achieving an average EWL of 44.5% and 55.3% at 6 months and 1 year, respectively. QOL scores improved at 6 months (p < 0.001) and 1 year (p = 0.049). In all patients, the 30-day mortality rate was 0%. The 1-year mortality rate for RYGB patients was 1.3%. Complication rates were acceptable, with 7% of RYGB patients experiencing a major postoperative complication.
Weight loss surgery is effective in patients ≥65 years of age, producing significant EWL, reduction in daily medication use, and improvement in QOL. Surgery is also associated with a low mortality rate and an acceptable morbidity profile.
- Ogden CL, Carrol MD, McDowell MA, Flegal KM. Obesity among adults in the United States—no change since 2003–2004,” NCHS data brief no. 1, Hyatsville, MD, National Center for Health Statistics, 2007.
- Decision Memo for Bariatric Surgery for the Treatment of Morbid Obesity (CAG-00250R). Available via: www.cms.hhs.gov Accessed Nov 11, 2007.
- Varela JE, Wilson SE, Nguyen N. Outcomes of bariatric surgery in the elderly. Am Surg. 2006;72:865–9.
- National Institutes of Health Consensus Development Conference Panel. National Institutes of Health conference: gastrointestinal surgery for severe obesity. Ann Intern Med. 1991;171:74–9.
- Quality of Life Inventory, Pearson Education, Inc., 2008. Available via: http://psychcorp.pearsonassessments.com. Accessed Feb 21, 2009.
- Longitudinal Assessment of Bariatric Surgery (LABS) Consortium. Perioperative safety in the longitudinal assessment of bariatric surgery. NEJM. 2009;361(5):445–54. CrossRef
- Flum DR, Salem L. Early mortality among Medicare beneficiaries undergoing bariatric surgical procedures. JAMA. 2005;294:1903–8. CrossRef
- Livingston EH, Langert J. The impact of age and Medicare status on bariatric surgical outcomes. Arch Surg. 2006;141:1115–20. CrossRef
- Fatima J, Houghton SG, Igbal CW. Bariatric surgery at the extremes of age. J Gastrointest Surg. 2006;10:1392–6. CrossRef
- Hallowell PT, Stelatto TA. Avoidance of complications in older patients and Medicare recipients undergoing gastric bypass. Arch Surg. 2007;142:506–12. CrossRef
- Trieu HT, Gonzalvo JP, Szomstein S. Safety and outcomes of laparoscopic gastric bypass surgery in patients 60 years of age and older. Surg Obes Relat Dis. 2007;3:383–6. CrossRef
- Dunkle-Blatter SE, St. Jean MR. Outcomes among elderly bariatric patients at a high-volume center. Surg Obes Relat Dis. 2007;3:163–70. CrossRef
- Hazzan D, Chin EH. Laparoscopic bariatric surgery can be safe for treatment of morbid obesity in patients older than 60 years. Surg Obes Relat Dis. 2006;2:613–6. CrossRef
- Quebbemann B, Engstrom D. Bariatric surgery in patients older than 65 years is safe and effective. Surg Obes Relat Dis. 2005;1:389–93. CrossRef
- Nelson LG, Lopez PP, et al. Outcomes of bariatric surgery in patients ≥65 years. Surg Obes Relat Dis. 2006;2:384–8. CrossRef
- Podnos Y, Jimenez J, et al. Complications after laparoscopic gastric bypass: a review of 3,464 cases. Arch Surg. 2003;138:957–61. CrossRef
- Nguyen NT et al. Result of a national audit of bariatric surgery performed at academic centers. Arch Surg. 2006;141:445–50. CrossRef
- Bariatric Surgery Outcomes in Patients Aged 65 Years and Older at an American Society for Metabolic and Bariatric Surgery Center of Excellence
Volume 20, Issue 9 , pp 1199-1205
- Cover Date
- Print ISSN
- Online ISSN
- Additional Links
- Bariatric surgery
- Weight loss surgery
- Age ≥65 years
- Industry Sectors
- Author Affiliations
- 1. Department of Surgery, Grand Rapids Medical Education and Research Center, 221 Michigan Avenue, Suite 200A, Grand Rapids, MI, 49503, USA
- 2. Grand Health Partners, 2060 E Paris Ave SE, Suite 100, Grand Rapids, MI, 49546, USA