Study: Mortality After Bariatric Surgery Not Higher for Elderly

CHICAGO - Older patients undergoing bariatric surgery had longer hospital stays, but no increased risk of death or major adverse events at 30 days, according to a study of more than 48,000 adults. The findings were presented at the annual Digestive Disease Week on May 9.

Patient age older than 65 years is not a contraindication to bariatric surgery, said Dr. Robert B. Dorman in a press conference in advance of the meeting. Previous studies of bariatric surgery in older adults have been limited to Medicare patients and have not included laparoscopic procedures, he noted.

In this multihospital study, Dr. Dorman of the University of Minnesota, Minneapolis, and his colleagues analyzed data from 48,378 adults with a body mass index of 35 kg/m² or higher who underwent bariatric surgery between 2005 and 2009. The patients were part of the American College of Surgeons National Surgical Quality Improvement Program.

The types of surgery included open and laparoscopic Roux-en-Y gastric bypass, open duodenal switch, laparoscopic adjustable gastric banding, and vertical banded gastroplasty.

The percentage of bariatric surgery patients aged 65 years or older increased from 1.9% in 2005 to 4.8% in 2009, a significant change. Among all patients, a total of 72 deaths occurred during the study period, and 8 of these occurred in patients aged 65 years or older.

The 30-day mortality did not differ significantly by age group and was under 1% for all age ranges. Specifically, for patients aged 35-49 years, 50-64 years, and 65 years and older mortality was 0.12%, 0.21%, and 0.40%, respectively. A multivariate analysis showed a trend for advancing age as a predictor of mortality, but this was not statistically significant, the researchers noted.

However, age of 65 years or older was a significant predictor of prolonged length of stay for both open and laparoscopic procedures. In addition, older age alone was not a significant predictor of major adverse events for either procedure type. The significant predictors of major adverse events included BMI of 55 or higher, cardiac comorbidities, severe ASA [American Society of Anesthesiologists] score, albumin levels less than 3 g/dL, and creatinine levels greater than 1.5 mg/dL.

“Once corroborated, these results [will] provide important information to patients, surgeons, hospitals, and payers prior to performing bariatric surgery in older persons with obesity,” Dr. Dorman said.

However, “we are certainly not giving the green light for bariatric surgeons to operate on these patients without determining their risk on an individual basis,” he added.

Dr. Dorman had no financial conflicts to disclos

CHICAGO - Older patients undergoing bariatric surgery had longer hospital stays, but no increased risk of death or major adverse events at 30 days, according to a study of more than 48,000 adults. The findings were presented at the annual Digestive Disease Week on May 9.

Patient age older than 65 years is not a contraindication to bariatric surgery, said Dr. Robert B. Dorman in a press conference in advance of the meeting. Previous studies of bariatric surgery in older adults have been limited to Medicare patients and have not included laparoscopic procedures, he noted.

In this multihospital study, Dr. Dorman of the University of Minnesota, Minneapolis, and his colleagues analyzed data from 48,378 adults with a body mass index of 35 kg/m² or higher who underwent bariatric surgery between 2005 and 2009. The patients were part of the American College of Surgeons National Surgical Quality Improvement Program.

The types of surgery included open and laparoscopic Roux-en-Y gastric bypass, open duodenal switch, laparoscopic adjustable gastric banding, and vertical banded gastroplasty.

The percentage of bariatric surgery patients aged 65 years or older increased from 1.9% in 2005 to 4.8% in 2009, a significant change. Among all patients, a total of 72 deaths occurred during the study period, and 8 of these occurred in patients aged 65 years or older.

The 30-day mortality did not differ significantly by age group and was under 1% for all age ranges. Specifically, for patients aged 35-49 years, 50-64 years, and 65 years and older mortality was 0.12%, 0.21%, and 0.40%, respectively. A multivariate analysis showed a trend for advancing age as a predictor of mortality, but this was not statistically significant, the researchers noted.

However, age of 65 years or older was a significant predictor of prolonged length of stay for both open and laparoscopic procedures. In addition, older age alone was not a significant predictor of major adverse events for either procedure type. The significant predictors of major adverse events included BMI of 55 or higher, cardiac comorbidities, severe ASA [American Society of Anesthesiologists] score, albumin levels less than 3 g/dL, and creatinine levels greater than 1.5 mg/dL.

“Once corroborated, these results [will] provide important information to patients, surgeons, hospitals, and payers prior to performing bariatric surgery in older persons with obesity,” Dr. Dorman said.

However, “we are certainly not giving the green light for bariatric surgeons to operate on these patients without determining their risk on an individual basis,” he added.

Dr. Dorman had no financial conflicts to disclos

CHICAGO - Older patients undergoing bariatric surgery had longer hospital stays, but no increased risk of death or major adverse events at 30 days, according to a study of more than 48,000 adults. The findings were presented at the annual Digestive Disease Week on May 9.

Patient age older than 65 years is not a contraindication to bariatric surgery, said Dr. Robert B. Dorman in a press conference in advance of the meeting. Previous studies of bariatric surgery in older adults have been limited to Medicare patients and have not included laparoscopic procedures, he noted.

In this multihospital study, Dr. Dorman of the University of Minnesota, Minneapolis, and his colleagues analyzed data from 48,378 adults with a body mass index of 35 kg/m² or higher who underwent bariatric surgery between 2005 and 2009. The patients were part of the American College of Surgeons National Surgical Quality Improvement Program.

The types of surgery included open and laparoscopic Roux-en-Y gastric bypass, open duodenal switch, laparoscopic adjustable gastric banding, and vertical banded gastroplasty.

The percentage of bariatric surgery patients aged 65 years or older increased from 1.9% in 2005 to 4.8% in 2009, a significant change. Among all patients, a total of 72 deaths occurred during the study period, and 8 of these occurred in patients aged 65 years or older.

The 30-day mortality did not differ significantly by age group and was under 1% for all age ranges. Specifically, for patients aged 35-49 years, 50-64 years, and 65 years and older mortality was 0.12%, 0.21%, and 0.40%, respectively. A multivariate analysis showed a trend for advancing age as a predictor of mortality, but this was not statistically significant, the researchers noted.

However, age of 65 years or older was a significant predictor of prolonged length of stay for both open and laparoscopic procedures. In addition, older age alone was not a significant predictor of major adverse events for either procedure type. The significant predictors of major adverse events included BMI of 55 or higher, cardiac comorbidities, severe ASA [American Society of Anesthesiologists] score, albumin levels less than 3 g/dL, and creatinine levels greater than 1.5 mg/dL.

“Once corroborated, these results [will] provide important information to patients, surgeons, hospitals, and payers prior to performing bariatric surgery in older persons with obesity,” Dr. Dorman said.

However, “we are certainly not giving the green light for bariatric surgeons to operate on these patients without determining their risk on an individual basis,” he added.

Dr. Dorman had no financial conflicts to disclos