Impact of Age on Obesity-Related Comorbidity After Gastric Bypass: A Cohort Study From the Scandinavian Obesity Surgery Registry (SOReg)
Causes and Prevention, Diagnosis; Prognosis
Cardiovascular, Diabetes, Kidney disease
Objective: To evaluate the resolution of obesity-related comorbidities after gastric bypass in relation to age.
Summary background data: Previous studies have shown that age > 60 years is associated with a significant, but small, increased risk of complications after gastric bypass. The effect in terms of improvement of obesity-related comorbidities in this group of patients is not studied.
Methods: Data on 57 215 patients operated with primary gastric bypass between May 2007 and December 2018 was extracted from the Scandinavian Obesity Surgery Registry, (SOReg). Odds ratio (OR) and 95% CI for resolution of comorbidities in five-years age groups at 1, 2 and 5 years postoperatively was calculated by logistic regression with the entire cohort of patients as reference. Resolution was defined as no longer in need for pharmacological (or CPAP) treatment.
Results: Follow-up rates in all eligible patients were 89, 69, and 59% at 1, 2, and 5 years, respectively and 64% in patients > 60 years at 5 years. At baseline, the prevalence of most comorbidities was higher in patients above 60 years. In this group of patients, the preoperative prevalence of diabetes, hypertension, dyslipidemia and OSAS was reduced at 5 years by 45, 10, 24, and 62%, respectively. Compared to all patients, the OR (95%CI) for resolution of these comorbidities in patients above 60 years at five years were 0.70 (0.57- 0.86) 0.45 (0.37 - 0.53), 0.80 (0.63 - 1.01) and 0.54 (0.40 - 0.72).
Conclusions: Although to somewhat lower rates compared to younger patients, marked and sustained improvements in obesity-related comorbidities are seen after gastric bypass in patients > 60 years. This, together with the finding that bariatric surgery is safe in this group of patients suggest that age should not be considered an exclusion criterion by itself.
Peter Gerber, Claes Anderin, Ulf O Gustafsson, Anders Thorell
Annals of Surgery