30-day Outcomes of Bariatric Surgery in Patients Over 75: Insights from the MBSAQIP Database.

BACKGROUND

Bariatric surgery is increasingly utilized in elderly populations as a treatment for morbid obesity, with demonstrated benefits in weight loss and comorbidity resolution. However, data on the safety and efficacy of these procedures in super-elderly patients remain limited, particularly regarding different types of surgical procedures.

OBJECTIVE

This study aimed to evaluate the incidence and nature of 30-day postoperative complications in patients aged 75 and older undergoing primary bariatric surgery as well as comparing the outcomes between SG and RYGB procedures.

METHODS

This retrospective cohort study analyzed super-elderly patients who underwent primary bariatric surgery between 2015 and 2023. Demographic, clinical, and surgical data were extracted from the MBSAQIP database. Patients were categorized into SG and RYGB groups, and 30-day outcomes, including morbidity, mortality, and specific complications, were assessed and compared.

RESULTS

A total of 2,539 patients (median age: 76 years, 64.8% women) were included. SG was the most commonly performed procedure (75%), followed by RYGB (21.2%). Within 30 days postoperative complications occurred in 10.4% of patients, with severe complications in 6.0%. Mortality was low (0.3%). SG demonstrated significantly lower rates of overall (8.7% vs. 15.8%) and severe complications (4.7% vs. 10.2%) compared to RYGB. Specific complications, including deep surgical site infections, bowel obstruction, and septic shock, were more prevalent in the RYGB group. Both groups had a median hospital stay of one day.

CONCLUSION

Bariatric surgery in super-elderly patients is associated with low morbidity and mortality rates within 30 days when appropriately optimized. SG, due to its lower 30-day complication rates, may be the preferred option for patients with higher surgical risk. These findings underscore the importance of individualized risk assessment and postoperative care in this high-risk population. Further research is needed to evaluate long-term outcomes and refine surgical protocols.