While the often impressive benefits of bariatric surgery on health and quality of life in younger patients with severe obesity are well documented, the safety and benefits of bariatric surgery in older patients remains largely unclear.

Now, a systematic review by my colleague Alexandra Chow from the University of Alberta, Edmonton, Canada, published in Obesity Surgery looks at outcomes in patients older than 65 years of age.

The review includes data from 8 studies (1835 patients) of roux-en-Y gastric bypass surgery, all of which were case series.

Overall mean excess weight loss was about 70{0d9774446e5c1c486b14bfd00f317fb53ff44ec6f4ca4ad04b1a0b82436e9f13}, which is only marginally less than generally seen in younger patients with this procedure.

Mean 30-day mortality was 0.14 {0d9774446e5c1c486b14bfd00f317fb53ff44ec6f4ca4ad04b1a0b82436e9f13} with a post-operative complication rate of around 20{0d9774446e5c1c486b14bfd00f317fb53ff44ec6f4ca4ad04b1a0b82436e9f13}, with wound infections being the most common (8 {0d9774446e5c1c486b14bfd00f317fb53ff44ec6f4ca4ad04b1a0b82436e9f13}) followed by cardiorespiratory complications (3 {0d9774446e5c1c486b14bfd00f317fb53ff44ec6f4ca4ad04b1a0b82436e9f13}).

Thus, it appears that bariatric surgery is reasonably safe and produces meaningful clinical outcomes in patients beyond 65 years of age.

Obviously, I would assume that these numbers are better than expected as centres (including ours) are rather selective about patients as they get older. Thus, these outcomes may not be applicable to every patient above the age of 65.

Nevertheless, it appears that for selected elderly patients, bariatric surgery may well be considered an effective treatment for severe obesity despite a reasonable measure of risk.

@DrSharma
Edmonton, AB

(c) Dr. Sharma’s Obesity Notes – Read entire story here.