Major Finding: The 30-day mortality did not differ significantly by age group and was under 1% for all age ranges.
Data Source: A multihospital study of 48,378 adults with a body mass index of 35 kg/m
Disclosures: Dr. Dorman had no financial conflicts to disclose.
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.
Patient age older than 65 years is not a contraindication to bariatric surgery, said Dr. Robert B. Dorman at the meeting. Previous studies in older adults have been limited to Medicare patients and have not included laparoscopic procedures, he noted.
In this multihospital study, using American College of Surgeons National Surgical Quality Improvement Program, 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/m
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 at least 65 years increased from 1.9% in 2005 to 4.8% in 2009, a significant change. Among all patients, 72 deaths occurred during the study period, and 8 of these occurred in patients older than 65.
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.