Advanced age and sex as predictors of adverse outcomes following gastric bypass surgery.
OBJECTIVE
This study aimed to determine whether advanced age or sex was predictive of adverse outcomes after Roux-en-Y gastric bypass.


METHODS
The Pennsylvania State Discharge Database was searched for records of morbidly obese patients who underwent Roux-en-Y gastric bypass. The SASs MIXED Procedure was used to test whether mortality alone or adverse outcomes (postoperative complications, nonroutine hospital transfer and mortality) were significantly related to sex or advanced age (>50 years). The presence of comorbidities was used as a blocking variable.


RESULTS
Between 1999 and 2001, 4,685 patients underwent Roux-en-Y gastric bypass in Pennsylvania, of which 82% were female and 20% were older than 50 years of age. Comorbidities were present in 71% of patients. Twenty-eight deaths (0.6%) and 813 adverse outcomes (17.4%) occurred. Mortality was greater in males than in females (1.2% vs. 0.47%, P<0.05) without comorbid interaction. Mortality did not increase with age. Adverse outcomes were related to both sexes (24% male, 16% female, P<0.05) and age (< or = 50, 16% vs. > 50, 23%, P<0.05) with a small comorbid interaction.


CONCLUSIONS
Adverse outcomes are more frequent among males and older patients and are influenced by comorbidities. Male patients have a higher mortality that was not affected by the presence of comorbidities.
Raftopoulos
Yannis
Y
Department of Surgery, Division of Thoracic and Foregut Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
Gatti
Guido G
GG
Luketich
James D
JD
Courcoulas
Anita P
AP
D000328:Adult; D000367:Age Factors; D000713:Anastomosis, Roux-en-Y; D015897:Comorbidity; D016208:Databases, Factual / Q000706:statistics & numerical data; D005260:Female; D015390:Gastric Bypass / Q000379:methods / Q000401:mortality; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D010414:Pennsylvania / Q000453:epidemiology; D011183:Postoperative Complications / Q000453:epidemiology*; D012307:Risk Factors; D012737:Sex Factors; D016896:Treatment Outcome