New Study Finds Gastric Bypass Surgery Not More
Risky for Senior Citizens Than Young
About 26% of seniors 65 and older in U.S. are
obese, nearly 40% are overweight, putting them at a higher risk for Type
2 diabetes, high blood pressure and heart disease
June 25, 2009 Morbidly obese seniors, age 65 and
over, who had laparoscopic gastric bypass surgery lost nearly 76 percent
of their excess weight after two years and had low complication rates
and short hospital stays comparable to younger surgical patients,
according to a new study presented today at the 26th Annual Meeting of
the American Society for Metabolic & Bariatric Surgery (ASMBS).
Bariatric surgery in the older population is
underutilized because of a misperception that old age alone puts
patients at higher risk for complications and mortality, said Joseph
Kuhn, MD, co-author and director of General Surgical Research at Baylor
University Medical Center in Dallas, TX.
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Read the latest news on Senior
Health & Medicine |
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We found seniors can benefit just as much as
younger people from bariatric surgery without taking on additional
risk.
In one of the largest series of laparoscopic
gastric bypass surgeries performed on elderly patients, researchers from
Baylor University Medical Center analyzed a prospective database of 100
patients over age 65 and compared safety and outcomes to a younger
population.
All patients had laparoscopic gastric bypass
surgery between January 2005 and July 2008.
Prior to surgery, older patients demonstrated
higher operative risk profiles compared to their younger counterparts in
relation to -
● sleep apnea (45% vs. 34%),
● Type 2 diabetes (65% vs. 33%) and
● hypertension (81% vs. 57%).
Older patients ranged in age from 65 to 77 with an
average BMI of 45, and younger patients ranged in age from 18 to 64 with
an average BMI of 47.
Post-operative excess body weight loss (EWL) and
complication rates were comparable in both groups.
At 12 and 24 months, both lost nearly the same
amount of weight -- patients over age 65 showed 75.9 percent EWL after
one year and 75.5 percent after two years; patients under 65 showed 77.8
percent EWL after one year and 79.2 percent after two years.
Neither group reported any deaths in the two-year
follow-up period.
Post-operative complications were -
● low: bleeding (>65 1% v. < 65 1.3%),
● pulmonary infections (>65 3% v. <65 1.3%),
● cardiac (>65 2% vs. <65 0.36%) and
● wound infections (>65 1% v. <65 1.7%).
Due to the age and overall health status of the
older group, researchers noted it was particularly interesting to also
find length of hospital stays (1.9 vs.1.3 days) and 30 day readmissions
rates (6% vs. 7.4%) to be so comparable.
About 26 percent of people 65 and older in the U.S.
are obese and another nearly 40 percent are overweight, putting them at
a higher risk for Type 2 diabetes, high blood pressure and heart
disease. Since 1990, the prevalence of obesity has increased more than
50 percent in the elderly.
The population is getting older and unfortunately
more obese, so we will see a corresponding increase in the number of
patients over 65 who are eligible for bariatric surgery and surgery
needs to be an option for them, said Christopher Willkomm, MD, study
co-investigator from Baylor University Medical Center.
People who are morbidly obese are generally 100 or
more pounds overweight, have a BMI of 40 or more, or a BMI of 35 or more
with an obesity-related disease, such as Type 2 diabetes, heart disease
or sleep apnea.
According to the ASMBS, more than 15 million
Americans are considered morbidly obese and in 2008 an estimated 220,000
people had some form of bariatric surgery. The most common methods of
bariatric surgery are laparoscopic gastric bypass and laparoscopic
adjustable gastric banding (LAGB).
The ASMBS is the largest organization for bariatric
surgeons in the world. It is a non-profit organization that works to
advance the art and science of bariatric surgery and is committed to
educating medical professionals and the lay public about bariatric
surgery as an option for the treatment of morbid obesity, as well as the
associated risks and benefits.
It encourages its members to investigate and
discover new advances in bariatric surgery, while maintaining a steady
exchange of experiences and ideas that may lead to improved surgical
outcomes for morbidly obese patients. For more information about the
ASMBS, visit
www.asmbs.org.
Information Source:
PL-207. Surgical Weight Loss Over 65 - Is It Worth
The Risk?
Christopher M. Willkomm, MD; Colleen Kennedy, MD; Tammy L. Fisher, RN;
Gregory Barnes, MD; Joseph A. Kuhn, MD; Surgery, Baylor University
Medical Center, Dallas, TX, USA
Background Information Sources
Rhoades, J. Overweight and Obese Elderly and Near
Elderly in the United States, 2002: Estimates for the
Noninstitutionalized Population Age 55 and Older. Statistical Brief #68.
February 2005. Agency for Healthcare and Research Quality, Rockville,
Md.
http://meps.ahrq.gov/mepsweb/data_files/publications/st68/stat68.pdf.
Physical Activity and Older Americans: Benefits and
Strategies. June 2002. Agency for Healthcare Research and Quality and
the Centers for Disease Control.
http://www.ahrq.gov/ppip/activity.htm.
