Bariatric Surgery in the Elderly Is Associated with Similar Surgical Risks and Significant Long-Term Health Benefits

Obes Surg. 2018 Aug;28(8):2165-2170. doi: 10.1007/s11695-018-3160-9.

Abstract

Purpose: Older age (> 60) has been considered a relative contraindication for bariatric surgery due to increased complication risk. This study examined the risks and benefits of bariatric surgery for patients older than 60 years in Canadian population.

Methods: This was a retrospective cohort study of the Ontario Bariatric Registry: a database recording peri-operative and post-operative outcomes of publicly funded bariatric surgeries across the province. Patients who completed 1 year follow-up, who underwent laparoscopic gastric bypass (LRYGB) or laparoscopic sleeve gastrectomy (LSG) between January 2010 and May 2013, were divided into older (> 60) and younger (> 60) cohorts, and outcomes were compared.

Results: Between January 2010 and May 2013, 3166 registry patients underwent LRYGB or LSG and completed 1-year follow-up. Of these, 204 (6.5%) were older than 60 years, with 175 (85.8%) undergoing LRYGB and 29 (14.2%) LSG. Demographics were similar, except for a higher number of males in the older group (59 (28.9%) versus 452 (15.3%) (p < 0.001)). No significant difference in complication rate was noted (15% for younger cohort versus 13.8% (p = 0.889)). The average percentage of excess weight loss was significantly higher in the younger population (60.72% versus 56.25% (p < 0.05)) overall, however not significantly in the LSG group. Reduction in medication use post-surgery for management of co-morbidities was significantly higher in the older patients (- 0.91 versus - 2.03 (p < 0.001)).

Conclusion: The older cohort who underwent LRYGB or LSG was at no greater risk for intra-operative and post-operative complications and showed greater reduction in medication use post-surgery when compared to the younger cohort.

Keywords: Bariatric surgery; Complication risk; Morbidity; Older age; Weight loss.

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Bariatric Surgery / adverse effects*
  • Bariatric Surgery / methods
  • Bariatric Surgery / statistics & numerical data
  • Comorbidity
  • Databases, Factual
  • Female
  • Follow-Up Studies
  • Humans
  • Laparoscopy / adverse effects
  • Laparoscopy / statistics & numerical data
  • Male
  • Middle Aged
  • Obesity, Morbid / epidemiology
  • Obesity, Morbid / surgery*
  • Ontario / epidemiology
  • Postoperative Complications / epidemiology*
  • Postoperative Complications / etiology
  • Retrospective Studies
  • Risk Assessment
  • Time Factors