Key result
Bariatric surgery in patients over 65 years was associated with a higher incidence of complications compared to patients under 65 years (37% vs 26%, p=0.002), with similar weight loss benefits.
Why the study?
Does conventional gastric bypass surgery provide safe and effective weight loss and comorbidity control in patients over 60 years old?
Cohort (n=46)
Does conventional gastric bypass surgery provide safe and effective weight loss and comorbidity control in patients over 60 years old?
Absolute Event Rate: 37% vs 26%
p-value: p=0.002
Bariatric surgery in patients over 65 years provides similar weight loss and comorbidity control as in those aged 60-64, but is associated with significantly higher surgical morbidity and mortality.
BACKGROUND: Surgical treatment of obesity in the elderly, particularly over 65, remains controversial; it is explained by the increased surgical risk or the lack of data demonstrating its long-term benefit. Few studies have evaluated the clinical effects of bariatric surgery in this population. AIM: To evaluate the results of surgical treatment of obesity in patients over 60 years, followed for an average period of five years. METHOD: This was a retrospective study evaluating 46 patients, 60 years or older, who underwent surgical treatment of obesity, by conventional gastric bypass technique (laparotomy). The average age was 64 years (60-71), mean BMI of 49.6 kg/m2 (38-66), mean follow-up of 5.9 years; 91% of patients were hypertensive, 56% diabetics and 39% had dyslipidemia. RESULTS: The incidence of complications (major and minor) in patients under 65 years was 26% and over 65 years 37% (p=0.002). There were no deaths in the group with less than 65 years and there were two deaths (12.5%) over 65 years. The average loss of overweight over 65 years or less was 72% vs 68% (p=0.56). There was total control of the diabetes mellitus in 77% and partial in 23%, with no difference between groups. There was improvement in arterial hypertension in 56% of patients, also no difference between groups. The average LDL levels did not differ between the pre and postoperative (106 mg/dl to 102 mg/dl), an increase of HDL (56 mg/dl to 68 mg/dL) and reduced triglyceride levels (136 mg/dl to 109 mg/dl). There was no statistical difference in the variation of the cholesterol fractions and triglycerides between the groups. Two patients in the group with less than 65 years died in late follow-up, of brain tumor and pneumonia, three and five years after bariatric surgery, respectively. CONCLUSIONS: Surgical morbidity and mortality were higher in patients over 65 years, and this group had the same benefits observed in patients lower 65 years for weight loss and comorbidities control.
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Pajecki et al. (2015) conducted a cohort in Obesity (n=46). Bariatric surgery in patients >65 years vs. Bariatric surgery in patients <65 years was evaluated on Incidence of complications (major and minor) (p=0.002). Bariatric surgery in patients over 65 years was associated with a higher incidence of complications compared to patients under 65 years (37% vs 26%, p=0.002), with similar weight loss benefits.
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