Study found few differences in adverse events, mortality, though hospital stay was longer

By Amanda Gardner
HealthDay Reporter 

MONDAY, May 9 (HealthDay News) -- Seniors can undergo weight-loss surgery without any worse side effects than younger people experience, new research shows.

"Age did not seem to be a significant predictor for mortality or major adverse events, but it did predict a longer period of hospital stay," said Dr. Robert B. Dorman, who is slated to present the findings Monday at Digestive Diseases Week in Chicago. Research presented at medical meetings should be viewed as preliminary.

"Assessing risk in the elderly will be a paramount issue, especially as Baby Boomers continue to age," added Dorman, who discussed the finding at an April 21 news conference. "Bariatric surgeons should proceed with caution in operating on an elderly obese patient. We are certainly not giving a green light to operate on these patients without determining individual risk."

There has been some debate on whether it is appropriate to perform this type of surgery on older obese patients.

According to Dr. Stephen Carryl, director of bariatric surgery at the Brooklyn Hospital Center in New York City, the National Institutes of Health has recommended that age 65 should be the cut-off point for bariatric surgery.

"That has become sort of the artificial standard," he said.

On the other hand, Medicare does pay for weight-loss surgery in this older population, he added.

These researchers looked at a database on close to 50,000 patients who underwent various types of weight-loss surgery between 2005 and 2009. About 4 percent were over 65, said Dorman, a general surgery resident at the University of Minnesota Medical School in Minneapolis.

More older people underwent bariatric surgery in 2009 than in 2005 (4.77 percent vs. 1.92 percent).

There was a trend toward more mortality in patients over the age of 65 but it wasn't significant, stated the authors.

Although older age was not correlated with adverse events such as heart attacks or blood clots, higher body-mass index (BMI), diabetes and chronic kidney failure were.

The only apparent drawback to having bariatric surgery when older, at least in this group, was a longer hospital stay.

But, showing the procedures are safe in an elderly population doesn't mean that folks over 65 will have access to them.

"Medicare is a small player in the bariatric population," Carryl said. "The majority have private medical insurance."

And not all commercial providers will pay for this in the older population.

More information

The U.S. National Library of Medicine has more on weight-loss surgery.

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SOURCES:

• Stephen Carryl, M.D., director, bariatric surgery, Brooklyn Hospital Center, New York City; April 21, 2011, teleconference with: Robert B. Dorman, M.D., Ph.D., general surgery resident, University of Minnesota Medical School, Minneapolis; May 9, 2011, presentation, Digestive Diseases Week, Chicago