Bariatric surgery outcomes in geriatric patients: a contemporary, nationwide analysis

Russyan Mark Mabeza; Yifan Mao; Kahtrel Maynard; Cory Lee; Peyman Benharash; Amy Yetasook

doi:10.1016/j.soard.2022.04.014

Bariatric surgery outcomes in geriatric patients: a contemporary, nationwide analysis

Surg Obes Relat Dis. 2022 Aug;18(8):1005-1011. doi: 10.1016/j.soard.2022.04.014. Epub 2022 Apr 22.

Authors

Russyan Mark Mabeza¹, Yifan Mao², Kahtrel Maynard³, Cory Lee⁴, Peyman Benharash⁴, Amy Yetasook⁵

Affiliations

¹ Cardiovascular Outcomes Research Laboratories (CORELAB), David Geffen School of Medicine, University of California, Los Angeles, California. Electronic address: russyan_mark_mabeza@alumni.brown.edu.
² David Geffen School of Medicine, University of California, Los Angeles, California.
³ Brown University, Providence, Rhode Island.
⁴ Cardiovascular Outcomes Research Laboratories (CORELAB), David Geffen School of Medicine, University of California, Los Angeles, California.
⁵ Department of Surgery, Harbor UCLA Medical Center, Torrance, California.

PMID: 35589528
DOI: 10.1016/j.soard.2022.04.014

Abstract

Objective: This retrospective study sought to characterize the incidence of mortality in elderly patients following bariatric surgery and assessed the association of geriatric status with postoperative outcomes and resource use.

Background: Bariatric surgery is a safe and efficacious intervention for obesity and related diseases. The clinical and economic impact of geriatric status on bariatric surgery is largely unexplored.

Setting: Academic, university-affiliated hospital; US.

Methods: Adults (≥45 yr) undergoing elective laparoscopic gastric bypass or sleeve gastrectomy were identified in the 2016-2019 Nationwide Readmissions Database. Patients ≥65 years were categorized into the geriatric cohort. Multivariable linear and logistic models were developed to evaluate the independent association of geriatric status with outcomes of interest.

Results: Of an estimated number of 351,292 patients meeting inclusion criteria, 44,183 (12.6%) comprised the geriatric cohort. Of these patients, .3% died during the index hospitalization. Geriatric status was associated with significantly increased odds of in-hospital mortality (adjusted odds ratio [AOR] = 2.39, 95% confidence interval [CI]: 1.33-4.30), respiratory (AOR = 1.34, 95% CI: 1.13-1.59), infectious (AOR = 1.65, 95% CI: 1.25-2.17), and renal complications (AOR = 1.27, 95% CI: 1.12-1.46), and prolonged hospitalization (AOR = 1.35, 95% CI: 1.24-1.48). Elderly patients experienced a .19-day increment in the length of stay (95% CI: .11-.27) and $620 in attributable hospitalization costs (95% CI: 310-930).

Conclusions: While overall rates of postoperative death and complications are low, geriatric patients experience significantly increased mortality, morbidity, and resource use following bariatric operations relative to younger adults. These findings may aid in shared decision-making for obesity management in geriatric patients.

Keywords: Costs; Gastric bypass; Geriatric; Outcomes; Sleeve gastrectomy.

MeSH terms

Adult
Aged
Bariatric Surgery*
Gastrectomy / adverse effects
Gastric Bypass* / adverse effects
Humans
Laparoscopy* / adverse effects
Obesity, Morbid* / complications
Postoperative Complications / etiology
Retrospective Studies