Association of Older Age with Early Postoperative Outcomes in Bariatric Surgery: The Role of Muscle Mass.

BACKGROUND/AIM: The aim of this study is to evaluate the early outcomes of metabolic bariatric surgery (MBS) in younger and older patients with obesity and to investigate the impact of muscle mass on the outcomes.

METHODS

The study included 155 younger and older patients who underwent MBS. Postoperative complications, length of hospital stay, and preoperative muscle mass were evaluated.

RESULTS

Older age was significantly associated with lower fat-free mass index (FFMI). Major complications were recorded only in older patients. The indirect effect of older age on early complications via FFMI was not significant, indicating that FFMI did not mediate the relationship between older age and in-hospital early complications in 72 h.

CONCLUSION

In older patients who underwent MBS, low FFMI values were not associated with in-hospital early complications in 72 h and did not mediate the relationship between older age and early complications. These findings suggest that decreased muscle mass alone may be insufficient to explain acute postoperative risk in MBS population. Prospective studies incorporating comprehensive geriatric evaluation, imaging-based body composition methods, and standardized 30-day outcome definitions are needed to more definitively characterize perioperative risk in older adults undergoing MBS.