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Impact of age on risk of complications after gastric bypass: A cohort study from the Scandinavian Obesity Surgery Registry (SOReg)
Department of Clinical Sciences, Danderyds Hospital, Karolinska Institutet, Stockholm, Sweden; Department of Surgery, Ersta Hospital, Stockholm, Sweden.
Department of Clinical Sciences, Danderyds Hospital, Karolinska Institutet, Stockholm, Sweden; Department of Surgery, Ersta Hospital, Stockholm, Sweden.
Örebro University, School of Medical Sciences. Örebro University Hospital. Department of Surgery, Örebro University Hospital, Örebro, Sweden.
Department of Surgery, Örebro University Hospital, Örebro, Sweden.
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2018 (English)In: Surgery for Obesity and Related Diseases, ISSN 1550-7289, E-ISSN 1878-7533, Vol. 14, no 4, p. 437-442Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: An increasing number of older patients undergo bariatric surgery.

OBJECTIVE: To define the risk for complications and mortality in relation to age after gastric bypass.

SETTING: A national registry-based study.

METHODS: Patients (n = 47,660) undergoing gastric bypass between May 2007 and October 2016 and registered in the Scandinavian Obesity Register were included. Risk between age groups was compared by multivariate analysis.

RESULTS: The 30-day follow-up rate was 98.1%. In the entire cohort of patients, any complication within 30 days was demonstrated in 8.4%. For patients aged 50 to 54, 55 to 59, and ≥60 years, this risk was significantly increased to 9.8%, 10.0%, and 10.2%, respectively. Rates of specific surgical complications, such as anastomotic leak, bleeding, and deep infections/abscesses were all significantly increased by 14% to 41% in patients aged 50 to 54 years, with a small additional, albeit not significant, increase in risk in patients of older age. The risk of medical complications (thromboembolic events, cardiovascular, and pulmonary complications) was significantly increased in patients aged ≥60 years. Mortality was .03% in all patients without differences between groups.

CONCLUSIONS: In this large data set, rates of complications and mortality after 30 days were low. For many complications, an increased risk was encountered in patients aged ≥50 years. However, rates of complications and mortality were still acceptably low in these age groups. Taking the expected benefits in terms of weight loss and improvements of co-morbidities into consideration, our findings suggest that patients of older age should be considered for surgery after thorough individual risk assessment rather than denied bariatric surgery based solely on a predefined chronologic age limit.

Place, publisher, year, edition, pages
Elsevier, 2018. Vol. 14, no 4, p. 437-442
Keywords [en]
Gastric bypass; age; elderly; complications; mortality
National Category
Surgery
Identifiers
URN: urn:nbn:se:oru:diva-66467DOI: 10.1016/j.soard.2017.12.024ISI: 000428971300001PubMedID: 29428689Scopus ID: 2-s2.0-85043981241OAI: oai:DiVA.org:oru-66467DiVA, id: diva2:1197622
Note

Funding Agency:

Erling-Persson Family Foundation

Available from: 2018-04-13 Created: 2018-04-13 Last updated: 2018-08-31Bibliographically approved

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Szabo, Eva

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