title: Gastric bypass for obesity in the elderly: is it as appropriate as for young and middle-aged populations?
abstract: BACKGROUND
  Obesity prevalence increases in elderly population. Bariatric surgery has been underused in patients over 60 because of fears of complications and lower weight loss. We postulated worse outcomes in the elderly in comparison to young and middle-aged population 1 year after gastric bypass.
  
  
  METHODS
  We retrospectively analyzed gastric bypass outcomes in young (<40 years), middle-aged (40 to 55 years), and elderly (>60 years) patients between 2007 and 2013. Each subject over 60 (n = 24) was matched with one subject of both the other groups according to gender, preoperative body mass index (BMI), surgical procedure, and history of previous bariatric surgery (n = 72).
  
  
  RESULTS
  Older subjects demonstrated higher prevalence of preoperative metabolic comorbidities (70 vs 30 % in the <40-year-old group, p < 0.0001). Mean duration of the surgical procedure, mean length of stay, and early and late complication rates were similar between age groups. A trend towards fewer early complications and less-severe complications in the younger groups was noted. One-year weight loss results were similar between young, middle-aged, and elderly patients (percentage of excess BMI loss (EBL%), 74.4 ± 3.5; 78.9 ± 4.5, and 73.7 ± 4.5 respectively, p = 0.69). Age was not predictive of weight loss failure 1 year after surgery. Remission and improvement rates of comorbidities were similar between age groups 6 months after surgery.
  
  
  CONCLUSIONS
  Our study confirms weight loss efficacy of gastric bypass in the elderly with acceptable risks. Further studies evaluating the benefit-risk balance of bariatric surgery in the elderly population will be required so as to confirm the relevance of increasing age limit.
authors.affiliation: Department of Digestive Surgery, Specialized and Integrated Center for Obesity Management, Hospices Civils de Lyon, Hôpital Edouard Herriot, 5, place d'Arsonval, 69437, Lyon, France, maud.robert@chu-lyon.fr.
authors.forename: Maud
authors.initials: M
authors.lastname: Robert
authors.forename: Arnaud
authors.initials: A
authors.lastname: Pasquer
authors.forename: Philippe
authors.initials: P
authors.lastname: Espalieu
authors.forename: Martine
authors.initials: M
authors.lastname: Laville
authors.forename: Christian
authors.initials: C
authors.lastname: Gouillat
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Disse
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D015992:Body Mass Index; D005260:Female; D015390:Gastric Bypass; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000601:surgery*; D012189:Retrospective Studies; D018570:Risk Assessment; D016896:Treatment Outcome; D015431:Weight Loss
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