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Bariatric Surgery

Outcomes of bariatric surgery in elderly patients: a registry-based cohort study with 3-year follow-up

International Journal of Obesity volume 46, pages 574–580 (2022)Cite this article

Subjects

Abstract

Background

Elderly patients undergo bariatric surgery less frequently than younger patients. Short- and medium-term outcomes after bariatric surgery in the elderly population remain largely unknown. The objective of the present retrospective, registry-based cohort study was to compare short- and medium-term outcomes between patients <65 and ≥65 years undergoing bariatric surgery, hypothesizing similar outcomes between groups.

Methods

In this retrospective, registry-based cohort study, the Ontario Bariatric Registry was used to compare data of patients <65 and ≥65 years who underwent Roux-en-Y gastric bypass and sleeve gastrectomy between January 2010 and August 2019 in all accredited bariatric centers of excellence in Ontario, Canada. Primary outcomes were overall postoperative complications. Secondary outcomes included early (<30 days) complications, readmissions, reoperations, mortality, weight loss and comorbidities improvement at 1 and 3 year after surgery.

Results

Data of 22,981 patients <65 and 532 patients ≥65 years were analyzed. Overall postoperative complications were similar between patients <65 and ≥65 years (3388/22,981 [14.7%] vs. 73/532 [13.7%], p = 0.537). Early (<30 days) postoperative complications, readmissions, reoperations, and mortality rates were also similar between groups. Both groups had significant weight loss and comorbidities improvement at 1- and 3-year follow-up. Patients <65 years had superior weight loss (+3.5%, 95% CI: 1.6–5.4, p < 0.001) and higher rates of remission for diabetes mellitus (63.8% vs. 39.3%, p < 0.001), hypertension (37.9% vs. 14.5%, p < 0.001), dyslipidemia (28.2% vs. 9.5%, p < 0.001) and gastroesophageal reflux (65.1% vs. 24.0 %, p < 0.001) compared to patients ≥65 years at 3 year.

Conclusions

Patients <65 and ≥65 years had similar perioperative morbidity and mortality after bariatric surgery. Even though patients <65 years had overall better medium-term outcomes, bariatric surgery is safe and yields significant weight loss and comorbidities improvement in patients ≥65 years.

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Authors and Affiliations

  1. Center for Minimal Access Surgery (CMAS), St. Joseph’s Healthcare, McMaster University, Hamilton, ON, Canada

    Pouya Iranmanesh, Vanessa Boudreau, Karim Ramji, Karen Barlow, Olivia Lovrics & Mehran Anvari

  2. Division of Digestive Surgery, Department of Surgery, Geneva University Hospital and Faculty of Medicine, Geneva, Switzerland

    Pouya Iranmanesh

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Contributions

PI: principal investigator—design and conception of the study, data collection, data analysis, interpretation of data, manuscript drafting. VB: design and conception of the study, interpretation of data, critical revision for important intellectual content. KR: interpretation of data, critical revision for important intellectual content. KB: data collection, data analysis, interpretation of data, critical revision for important intellectual content. OL: data collection, interpretation of data, critical revision for important intellectual content. MA: design and conception of the study, interpretation of data, critical revision for important intellectual content. All authors approve the final version of the manuscript to be published and all authors agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. All authors fulfill the four ICMJE criteria for authorship.

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Correspondence to Pouya Iranmanesh.

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Iranmanesh, P., Boudreau, V., Ramji, K. et al. Outcomes of bariatric surgery in elderly patients: a registry-based cohort study with 3-year follow-up. Int J Obes 46, 574–580 (2022). https://doi.org/10.1038/s41366-021-01031-w

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