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Surgical Morbidity in the Elderly Bariatric Patient: Does Age Matter?

Obesity Surgery volume 29, pages 2548–2552 (2019)Cite this article

A Correction to this article was published on 07 June 2019

This article has been updated

Abstract

Background

Obesity is a global health problem that also affects older adults. In Chile, as in most of the developing countries, more than half of older adults are overweight or obese, and bariatric surgery may be riskier for this group. The aim of this study is to compare our experience in patients over 60 years of age with a control group to determine associated surgical morbidity and mortality.

Methods

Case-control study of bariatric surgeries performed between 2006 and 2017 in our institution. Patients aged ≥ 60 years for the case group versus control group for patients ≤ 50 years selected randomly, matched by body mass index, type 2 diabetes, hypertension, dyslipidemia, surgical technique, and gender (ratio 1:2). Primary endpoint was surgical morbidity, 30-day readmission, and mortality.

Results

Seventy-two patients in case group were matched with 144 patients in control group. Surgical complications rate was the same for both groups. No differences were observed in the conversion to open surgery rate or 30-day readmission rate. There was no mortality in this series.

Conclusion

In this case-control study, being elderly does not increase the risk of morbidity and mortality associated with bariatric surgery.

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Change history

  • 07 June 2019

    Due to a metadata tagging error the name of author Andrés Esteban San Martín was indexed incorrectly. The author’s given name is Andrés Esteban and his family name is San Martín.

References

  1. World Health Organization, Obesity and Overweight, WHO, 2015 (updated January 2015). Disponible en: http://www.who.int/mediacentre/factsheets/fs311/en/. Accessed on January 2019.

  2. Wang Y, Yi X, Li Q, et al. The effectiveness and safety of sleeve gastrectomy in the obese elderly patients: a systematic review and meta-analysis. Obes Surg. 2016;16(12):3023–30.

    Article  Google Scholar 

  3. Navarrete A, Corcelles R, Del Gobbo GD, et al. Sleeve gastrectomy in the elderly: a case-control study with long-term follow-up of 3 years. Surg Obes Relat Dis. 2017 Apr;13(4):575–80. https://doi.org/10.1016/j.soard.2016.11.030.

    Article  PubMed  Google Scholar 

  4. Giordano S, Victorzon M. Laparoscopic Roux-en-Y gastric bypass in elderly patients (60 years or older): a meta-analysis of comparative studies. Scand J Surg. 2018;107(1):6–13.

    CAS  Article  Google Scholar 

  5. Livingston E, Langert J. The impact of age and Medicare status on bariatric surgical outcomes. Arch Surg. 2006;141(11):1115–20; discussion 1121.

    Article  Google Scholar 

  6. Marczuk P, Kubisa MJ. Effectiveness and safety of Roux-en-Y gastric bypass in elderly patients—systematic review and meta-analysis. Obes Surg. 2019;29:361–8.

    Article  Google Scholar 

  7. Alamo M, Sepúlveda C, Zapata L. Vertical isolated gastroplasty with gastro-enteral bypass: preliminary results. Obes Surg. 2006;16(3):353–8.

    Article  Google Scholar 

  8. Alamo M, Sepulveda M, Gellona J, et al. Sleeve gastrectomy with jejunal bypass for the treatment of type 2 diabetes mellitus in patients with body mass index. Obes Surg. 2012;22(7):1097–103.

    Article  Google Scholar 

  9. Sepulveda M, Alamo M, Preiss Y, Valderas JP. Metabolic surgery comparing sleeve gastrectomy with jejunal bypass and Roux-en-Y gastric bypass in type 2 diabetic patients after 3 years. August 2018. First online. 2018. https://doi.org/10.1007/s11695-018-3402-x.

    Article  Google Scholar 

  10. St Peter SD, Craft RO, Tiede JL, et al. Impact of advanced age on weight loss and health benefits after laparoscopic gastric bypass. Arch Surg. 2005;140:165–8.

    Article  Google Scholar 

  11. Yoon J, Sherman J, Argiroff A, et al. Laparoscopic sleeve gastrectomy and gastric bypass for the aging population. Obes Surg. 2016;26(11):2611–5. https://doi.org/10.1007/s11695-016-2139-7.

    Article  PubMed  Google Scholar 

  12. 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;24:1662–9.

    Article  Google Scholar 

  13. Luppi CR, Balague C, Targarona EM, et al. Laparoscopic sleeve gastrectomy in patients over 60 years: impact of age on weight loss and co-morbidity improvement. Surg Obes Relat Dis. 2015;11(2):296–301.

    Article  Google Scholar 

  14. 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;25:2251–6.

    Article  Google Scholar 

  15. van Rutte PWJ, Smulders JF, de Zoete JP, et al. Sleeve gastrectomy in older obese patients. Surg Endosc. 2013;27(6):2014–9.

    Article  Google Scholar 

  16. 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(7):403–10.

    PubMed  Google Scholar 

  17. Willkomm CM, Fisher TL, Barnes GS, et al. Surgical weight loss > 65 years old: is it worth the risk? Surg Obes Relat Dis. 2018;6(5):491–6.

    Article  Google Scholar 

  18. Mizrahi I, Alkurd A, Ghanem M, et al. Outcomes of laparoscopic sleeve gastrectomy in patients older than 60 years. Obes Surg. 2014;24(6):855–60.

    Article  Google Scholar 

  19. Leivonen MK, Juuti A, Jaser N, et al. Laparoscopic sleeve gastrectomy in patients over 59 years: early recovery and 12-month follow-up. Obes Surg. 2011;21(8):1180–7.

    Article  Google Scholar 

  20. Gonzalez-Heredia R, Patel N, Sanchez-Johnsen L, et al. Does age influence bariatric surgery outcomes? Bariatr Surg Pract Patient Care. 2015;10(2):74–8.

    Article  Google Scholar 

  21. 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;

  22. Chow A, Switzer NJ, Gill RS, et al. Roux-en-Y gastric bypass in the elderly: a systematic review. Obes Surg. 2015;26(3):626–30. https://doi.org/10.1007/s11695-015-2007-x.

    Article  Google Scholar 

  23. Thereaux J, Poitou C, Barsamian C, et al. Midterm outcomes of gastric bypass for elderly (aged ≥ 60 yr) patients: a comparative study. Surg Obes Relat Dis. 2015;11(4):836–41.

    Article  Google Scholar 

  24. Dunkle-Blatter SE, St Jean MR, Whitehead C, et al. Outcomes among elderly bariatric patients at a high-volume center. Surg Obes Relat Dis. 2007;3(2):163–9. discussion169–70

    Article  Google Scholar 

  25. Tiwari MM, Goede MR, Reynoso JF, et al. Differences in outcomes of laparoscopic gastric bypass. Surg Obes Relat Dis. 2011;7(3):277–82.

    Article  Google Scholar 

  26. Vinan-Vega M, Diaz Vico T. Bariatric surgery in the elderly patient: safety and short-time outcome. A case match analysis. Obes Surg. 2018;29:1007–11. https://doi.org/10.1007/s11695-018-03633-2.

    Article  Google Scholar 

  27. Organización Panamericana de la Salud, con base en datos del Departamento de Asuntos Económicos y Sociales de las Naciones Unidas. División de Población. Revisión 2017. www.paho.org/salud-en-las-americas-2017.

  28. Aguilera X, González C, Matute I, Najera M, Olea N. Las enfermedades no transmisibles en Chile: aspectos epidemiológicos y de salud pública. Serie Salud Poblacional. Santiago: Universidad del Desarrollo, Facultad de Medicina, Centro de Epidemiología y Políticas de Salud; 2016. http://repositorio.udd.cl/handle/11447/1460?show=full. Accessed on January 2019.

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Acknowledgments

The authors thank statistics Professor Waldo Aranda, from the School of Medicine of Universidad Diego Portales for his valuable help in the statistical analysis and in writing the “Methods” section.

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Authors and Affiliations

  1. Escuela de Medicina, Universidad Diego Portales, Av. Ejército Libertador, 141, Santiago, Chile

    Andrés San Martín & Matías Sepúlveda

  2. Bariatric and Metabolic Surgery Center, DIPRECA Hospital, Vital Apoquindo 1200, Las Condes, Santiago, Chile

    Matías Sepúlveda, Hernán Guzmán, Felipe Patiño & Yudith Preiss

  3. Escuela de Medicina, Universidad de Santiago, Av Libertador Bernardo O’Higgins, 3363, Santiago, Chile

    Felipe Guzman

Authors
  1. Andrés San Martín
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  2. Matías Sepúlveda
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Corresponding author

Correspondence to Matías Sepúlveda.

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Martín, A.S., Sepúlveda, M., Guzman, F. et al. Surgical Morbidity in the Elderly Bariatric Patient: Does Age Matter?. OBES SURG 29, 2548–2552 (2019). https://doi.org/10.1007/s11695-019-03876-7

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  • DOI: https://doi.org/10.1007/s11695-019-03876-7

Keywords

  • Bariatric surgery
  • Elderly
  • Morbidity
  • Mortality
  • Risk factors