Bariatric Surgery Outcomes in Patients Aged 65 Years and Older at an American Society for Metabolic and Bariatric Surgery Center of Excellence

Background: Although morbid obesity rates in patients >or=65 years of age are increasing, few centers have reported weight loss surgery outcomes in elderly patients, resulting in a paucity of literature on perioperative mortality and morbidity.

Methods: A retrospective analysis was performed on 197 consecutive patients >or=65 years old who underwent weight loss surgery from January 2000 to December 2007. Primary data points included 30-day and 1-year mortality rates, length of stay (LOS), percent excess weight loss (EWL), change in daily medication use, and quality of life (QOL).

Results: The average patient's age was 67.3 years with 72.1% being female. Average preoperative weight and BMI were 131.9 kg and 48.1 kg/m(2), respectively. Average preoperative daily medication use was 8.04 +/- 3.67. Procedure types included Roux-en-Y gastric bypass (79.3%), adjustable gastric banding (17.2%), and vertical sleeve gastrectomy (3%). Ninety-seven percent of procedures were performed laparoscopically. Average LOS was 2.0 +/- 2.1 days. Average weight, BMI, and daily medication use were significantly reduced at 6 months and 1 year (p < 0.001), with patients achieving an average EWL of 44.5% and 55.3% at 6 months and 1 year, respectively. QOL scores improved at 6 months (p < 0.001) and 1 year (p = 0.049). In all patients, the 30-day mortality rate was 0%. The 1-year mortality rate for RYGB patients was 1.3%. Complication rates were acceptable, with 7% of RYGB patients experiencing a major postoperative complication.

Conclusions: Weight loss surgery is effective in patients >or=65 years of age, producing significant EWL, reduction in daily medication use, and improvement in QOL. Surgery is also associated with a low mortality rate and an acceptable morbidity profile.