Bariatric surgery in elderly patients: a systematic review

Giordano, Salvatore; Victorzon, Mikael

doi:10.2147/cia.s70313

Cited by 83 publications

(44 citation statements)

References 58 publications

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“…In earlier times, several national and international guidance's recommended that weight loss surgical interventions should be restricted to patients under 60 years old based on the concerns of age-related increased surgical risks ( 27 ). Nonetheless, as the amount of clinical evidence enlarged, it became recognizable that the surgical outcomes of bariatric surgery, including morbidity and mortality rates, in older patients were not significantly different than those observed in younger ones ( 28 – 31 ). Thus, the number of bariatric procedures performed in older patients has increased over the past decades ( 32 , 33 ).…”

Section: Discussionmentioning

confidence: 99%

Diabetic and Elder Patients Experience Superior Cardiovascular Benefits After Gastric Bypass Induced Weight Loss

et al. 2018

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Background/Objetives: Obesity and obesity related co-morbidities are well-recognized risks for cardiovascular (CV) disease and mortality. Weight loss improves CV risk factors and the efficacy of bariatric surgery in decreasing CV mortality is now well-established. Our aim was to assess CV risk progression and occurrence of CV events in a cohort of patients that underwent Roux-en-Y gastric bypass (RYGB) for obesity treatment in a single academic public center.Subjects and Methods: Ten year CV risk was estimated using the Framingham Equation at baseline and 2 years after RYGB surgery in our patients cohort (n = 260). In the subgroup with a follow-up time longer than 4 years after surgery (n = 185; mean 5.4 ± 0.1 years), CV risk adjusted for the time length after RYGB was similarly estimated and the occurrence of CV events for outcome adjudication was monitored during the same time period by reviewing the hospital patients' record, the electronic national health system patient register and our center outpatient clinic records.Results: Ten year CV risk was significantly reduced 2 years after surgery when compared to baseline, with reductions of 1.65 ± 0.25% in the risk of CV disease. Patients with prior type 2 diabetes and aged 50 years or older experienced a significantly superior CV risk reduction, with diabetic patients experiencing a reduction of their 10–year CV disease risk of 3.58 ± 1.11% vs. a reduction of 1.31 ± 0.20% in non-diabetic patients and with the 10–year risk of CV disease dropping 3.41 ± 0.75% in patients older than 50 vs. a reduction of 0.99 ± 0.18 in patients up to 50 years. For the subgroup of patients with a longer follow-up time, baseline CV risk estimation predicted the occurrence of 6.08 ± 0.56 cardiovascular disease (CVD) events, 3.87 ± 0.39 coronary heart disease (CHD) events, 1.49 ± 0.22 myocardial infarctions (MI), 0.71 ± 0.09 strokes, 0. 28 ± 0.05 deaths from CHD and 0.35 ± 0.05 deaths from CVD. No CV events were adjudicated in this subgroup during follow-up.Conclusions: RYGB significantly improves CV risk and prevents the occurrence of CV events. For similar weight loss, diabetic and elder patients experience a superior CV risk improvement and may have additional CV benefits after bariatric surgery.

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Section: Discussionmentioning

confidence: 99%

Diabetic and Elder Patients Experience Superior Cardiovascular Benefits After Gastric Bypass Induced Weight Loss

et al. 2018

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“…Older age is a predictor of increased length of hospital stay, although there is no significant increase in mortality. This has been shown in studies that found individuals over 65 to be most likely to require prolonged hospitalization 25 , 26 . Robert et al .…”

Section: Discussionmentioning

confidence: 76%

Safety and effectiveness of laparoscopic Y-en-Roux gastric bypass surgery in obese elderly patients

et al. 2020

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Purpose To analyze, in aged obese patients, the weight loss, comorbidity control, and safety postoperative complications of bariatric surgery by Roux-en-Y gastric bypass technique. Methods Twenty-seven patients who underwent laparoscopic weight-reducing gastroplasty with Roux-en-Y gastric bypass to treat obesity were included. All patients were ≥ 60 years old at the time of surgery. The Wilcoxon test was used for statistical analysis, and a p-value ≤0.05it was considered significant. Results Ten (90.9%) patients with dyslipidemia were cured (p < 0.001). Nine (81.8%) patients with type 2 diabetes mellitus had total improvement and 2 (18.2%) had partial improvement (p = 0.003). In 23 patients with systemic arterial hypertension, 9 (39.1%) achieved total improvement and 14 (60.9%) partial improvement (p = 0.140). Five (71.4%) patients with obstructive sleep apnea syndrome were cured (p = <0.001). For other comorbidities, no partial improvement or cure was shown. Conclusions Roux-en-Y gastric bypass surgery in obese elderly patients can be performed safely and with low morbidity and mortality rates. The benefits of weight loss and reduced comorbidities are promising and like those of the younger population.

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“…In bariatric surgery, however, this is considered a valuable diagnostic tool. When compared to international literature, the number of serious complications was significantly lower in DATO [ 4 , 31 ].…”

Section: Discussionmentioning

confidence: 92%

“…Bariatric procedures were considered relatively safe, regarding to other surgical interventions, where mortality and morbidity were considered acceptable [ 1 , 4 , 31 , 32 ]. With 16 deaths out of 21,634 unique patients in the past 2 years, bariatric surgery in the Netherlands can be considered relatively safe.…”

Section: Discussionmentioning

confidence: 99%

A Dutch Nationwide Bariatric Quality Registry: DATO

Poelemeijer

Liem²,

Nienhuijs

2017

OBES SURG

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IntroductionIn the Netherlands, the number of bariatric procedures increased exponentially in the 90s. To ensure and improve the quality of bariatric surgery, the nationwide Dutch Audit for Treatment of Obesity (DATO) was established in 2014. The audit was coordinated by the Dutch Institute for Clinical Auditing (DICA). This article provides a review of the aforementioned process in establishing a nationwide registry in the Netherlands.Materials and MethodsIn collaboration with the DATO’s scientific committee and other stakeholders, an annual list of several external quality indicators was formulated. This list consists of volume, process, and outcome indicators.In addition to the annual external indicators, the database permits individual hospitals to analyze their own data. The dashboard provides several standardized reports and detailed quality indicators, which are updated on a weekly base.ResultsSince the start, all 18 Dutch bariatric centers participated in the nationwide audit. A total of 21,941 cases were registered between 2015 and 2016. By 2016, the required variables were registered in 94.3% of all cases. A severe complicated course was seen in 2.87%, and mortality in 0.05% in 2016. The first-year follow-up shows a > 20% TWL in 86.1% of the registered cases.DiscussionThe DATO has become rapidly a mature registry. The well-organized structure of the national audit institution DICA and governmental funding were essential. However, most important were the bariatric teams themselves. The authors believe reporting the results from the registry has already contributed to more knowledge and acceptance by other health care providers.

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Bariatric surgery in elderly patients: a systematic review

Cited by 83 publications

References 58 publications

Diabetic and Elder Patients Experience Superior Cardiovascular Benefits After Gastric Bypass Induced Weight Loss

Diabetic and Elder Patients Experience Superior Cardiovascular Benefits After Gastric Bypass Induced Weight Loss

Safety and effectiveness of laparoscopic Y-en-Roux gastric bypass surgery in obese elderly patients

A Dutch Nationwide Bariatric Quality Registry: DATO

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