Bariatric Procedures in Older Adults in the United States: Analysis of a Multicenter Database

• Main Authors: Priya Mendiratta, Neeraj Dayama, Gohar Azhar, Pallavi Prodhan, Jeanne Y. Wei
• Format: Article
• Language: English
• Published: MDPI AG 2019-04-01
• Series: Geriatrics
• Subjects: older adults; bariatric procedures; outcomes
• Online Access: https://www.mdpi.com/2308-3417/4/2/32

Background<i>:</i> Bariatric procedures help reduce obesity-related comorbidities and thus improve survival. Clinical characteristics and outcomes after bariatric procedures in older adults were investigated. Methods<i>:</i> A multi-institutional Nationwide Inpatient Sample (NIS) database was queried from years 2005 through 2012. Older adults &gt;60 years of age with procedure codes for bariatric procedures and a diagnosis of obesity/morbid obesity were selected to compare clinical characteristics/outcomes between those undergoing closed versus open procedures and identify risk factors associated with in-hospital mortality and increased hospital length of stay (LOS). Results<i>:</i> Over the study period, 79,122 bariatric procedures were performed. Those undergoing open procedures compared to closed procedures had a higher in-hospital mortality (0.8% vs. 0.2%) and a longer hospital LOS (4.8 days vs. 2.2 days). Risk factors significantly associated with in-hospital mortality were open procedures, the Western region, and the Elixhauser comorbidity index. Risk factors associated with increased LOS were Medicaid insurance type, an open procedure, a higher Elixhauser comorbidity score, a required skilled nursing facility (SNF) discharge, and died in hospital. Conclusion<i>:</i> Closed bariatric procedures are increasingly being preferred in older adults, with a four-fold lower mortality compared to open procedures. Besides choice of procedure, the presence of specific comorbidities is associated with increased mortality in older adults.