Perioperative and 1-year outcomes of bariatric surgery in septuagenarians: implications for patient selection
Abstract
Background Although bariatric surgery is an effective treatment for obesity, utilization of bariatric procedures in older adults remains low. Previous work reported higher morbidity in older patients undergoing bariatric surgery. However, the generalizability of these data to contemporary septuagenarians is unclear.Objectives We sought to evaluate differences in 30-day outcomes, 1-year weight loss, and co-morbidity remission after bariatric surgery among 3 age groups as follows: <45 years, 45-69 years, and ≥70 years.Setting Statewide quality improvement collaborative.Methods Using a large quality improvement collaborative, we identified patients undergoing sleeve gastrectomy (SG) or Roux-en-Y gastric bypass (RYGB) between 2006 and 2018. We used multivariable logistic regression models to evaluate the association between age cohorts and 30-day outcomes, 1-year weight loss, and co-morbidity remission.Results We identified 641 septuagenarians who underwent SG (68.5%) or RYGB (31.5%). Compared with 45-69 year olds, septuagenarians had higher rates of hemorrhage (5.1% versus 3.1%; P = .045) after RYGB and higher rates of leak/perforation (.9% versus .3%; P = .044) after SG. Compared with younger patients, septuagenarians lost less of their excess weight, losing 64.8% after RYGB and 53.8% after SG. Remission rates for diabetes and obstructive sleep were similar for patients aged ≥70 years and 45-69 years.Conclusions Bariatric surgery in septuagenarians results in substantial weight loss and co-morbidity remission with an acceptable safety profile. Surgeons with self-imposed age limits should consider broadening their selection criteria to include patients ≥70 years old.
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In septuagenarians, MBS is associated with slightly higher rates of postoperative complications compared with a younger population, but still provides substantial benefits of weight loss and remission of co-morbid disease.
“In septuagenarians MBS is associated with slightly higher rates of postoperative complications compared with a younger population, but still provides substantial benefits of weight loss and remission of co-morbid disease [46].”
MBS has been performed successfully in increasingly older patients over the past few decades, including individuals >70 years of age.
“Coincident with the demonstrated safety of MBS, surgery has been performed successfully in increasingly older patients over the past few decades, including individuals >70 years of age [45, 46].”
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- Authors
- Smith, M. E., Bacal, D., Bonham, A. J., Varban, O. A., Carlin, A. M., Ghaferi, A. A., & Finks, J. F.
- Affiliations
- University of Michigan (US)
- Beaumont Hospital, Dearborn (US)
- Henry Ford Health (US)
- Corresponding author
- Smith, Margaret E.
- ORCID
- Venue
- Surgery for Obesity and Related Diseases
- Publisher
- Elsevier BV
- Published
- 2019-10
- Volume
- 15
- Issue
- 10
- Pages
- 1805-1811
- ISSN
- 1550-7289 (ISSN-L)
- PMC
- PMC6834898
- OpenAlex
- W2968569630
- Cited by
- 30
- References
- 28
- Citations by year
- 2026: 2 · 2025: 5 · 2024: 6 · 2023: 5 · 2022: 4 · 2021: 6 · 2020: 2
- FWCI
- 2.86
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Surgery for Obesity and Related Diseases (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health
- Topics
- Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
- Health Sciences › Medicine › Surgery › Body Contouring and Surgery
- Health Sciences › Medicine › Surgery › Minimally Invasive Surgical Techniques
- Keywords
- bariatric surgery, septuagenarians
- MeSH terms
- Adult, Age Factors, Aged, Female, Humans, Male, Middle Aged, Obesity, Morbid, Postoperative Complications, Gastroplasty, Weight Loss, Comorbidity, Treatment Outcome, Patient Selection, Bariatric Surgery
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