Bariatric surgery in elderly patients: a systematic review

Area of Science:

• Geriatric Medicine
• Surgical Innovation
• Metabolic Health

Background:

• Bariatric/metabolic surgery is increasingly considered for elderly patients, but its effectiveness and safety remain debated.
• Evidence on surgical outcomes in this demographic is crucial for clinical decision-making.

Purpose of the Study:

• To systematically review the outcomes and safety of bariatric surgery in patients aged 60 years and older.
• To compare surgical results in elderly individuals with those reported in younger populations.

Main Methods:

• A comprehensive systematic review of multiple databases (MEDLINE, Cochrane Library, Embase, Scopus, Google Scholar) was conducted.
• Pooled proportions and 95% confidence intervals were calculated for mortality, complications, and resolution of comorbidities.
• A random-effects model was employed to evaluate heterogeneity across 26 included studies involving 8,149 patients.

Main Results:

• The pooled 30-day postoperative mortality was low at 0.01%, with an overall complication rate of 14.7%.
• At 1-year follow-up, significant improvements were observed: 53.77% excess weight loss, 54.5% diabetes resolution, 42.5% hypertension resolution, and 41.2% lipid disorder resolution.
• Outcomes and complication rates were comparable to younger patient groups, irrespective of the surgical procedure.

Conclusions:

• Bariatric surgery demonstrates comparable safety and efficacy in patients over 60 years old to that in younger populations.
• Age should not be a sole contraindication for bariatric surgery in the elderly.
• This review supports considering bariatric surgery for elderly individuals based on individual health status and potential benefits.