Exploring perioperative outcomes in metabolic and bariatric surgery amongst the elderly: an analysis of the 2015-2017 MBSAQIP database.

Publication/Presentation Date

6-1-2021

Abstract

BACKGROUND: Metabolic and bariatric surgery (MBS) is increasingly performed in patients >65 years. Studies of perioperative outcomes have shown equivocal results.

OBJECTIVES: Our study objective was to explore perioperative outcomes in elderly MBS patients compared with those <65 >years.

SETTING: Academic Hospital.

METHODS: Primary sleeve (SG) and gastric bypass (RYGB) cases were identified from the 2015-2017 Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) database. Selected cases were stratified by age (≥65 yr versus <65 >yr). Univariate and multivariate logistic regression analyses were performed comparing outcomes in the elderly with the general MBS cohort.

RESULTS: 26,557 (5.6%) of MBS cases were performed in elderly patients, who were more likely to be white, male, have a lower mean body mass index (BMI), receive a gastric bypass, and robotic-assisted surgery. Elderly patients had a significantly higher disease burden, and most outcome measures were significantly higher in elderly patients, including mortality and morbidity. On multivariate regression analyses, elderly patients undergoing SG have significantly less risk of mortality and morbidity compared with RYGB. In general, co-morbidities were in most cases more strongly predictive of complications than age alone. The number needed to harm (NNH) for overall and related morbidity were 59 and 232, respectively.

CONCLUSION: Elderly MBS patients have higher disease burden and higher adverse outcomes following MBS; however, complications in this cohort remain overall rare. When performing bariatric surgery on elderly patients, procedure consideration should favor SG as RYGB is independently associated with worse outcomes.

Volume

17

Issue

6

First Page

1096

Last Page

1106

ISSN

1878-7533

Disciplines

Medicine and Health Sciences

PubMedID

33785272

Department(s)

Department of Surgery

Document Type

Article

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