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Seniors more at risk for complications, death from large scale weight-loss surgery
November 28, 2006The first large-scale review of weight-loss surgeries performed on older adults suggests bariatric procedures should generally be limited to people younger than age 65, researchers at UT Southwestern Medical Center have found.
The study showed that older patients experienced less weight loss and far more complications than younger patients, indicating that the risks often outweigh the benefits of these types of surgeries in older patients. The study, which appears in the Archives of Surgery, reviewed more than 25,000 bariatric procedures from a national database.
"Adverse outcomes increased with age, particularly after age 60," said Dr. Edward Livingston, chairman of GI/endocrine surgery at UT Southwestern and the study's lead author. "Beyond 65 years of age, the adverse event rate exceeded 20 percent and mortality was 3.23 percent."
In addition to age, the study found that men and those with electrolyte disorders and congestive heart failure were at greater risk of death from bariatric surgery or related complications, said Dr. Livingston.
Other conditions that increased risk for adverse events and required longer hospital stays included chronic pulmonary disease, diabetes and depression.
Common complications included gastrointestinal, respiratory and cardiac problems. Gastrointestinal problems were most common, occurring in about 30 percent of older patients who had complications. Respiratory-tract problems occurred in about 20 percent of patients with post-operative problems. Cardiac complications affected about 15 percent of elderly patients.
The Centers for Disease Control and Prevention estimates that nearly one-third of adult Americans - more than 60 million people - are obese. Nearly 5 percent of adults are classified as extremely obese. The American Society for Bariatric Surgery Foundation estimates that more than 1,000 people die each day from obesity-related complications. Obese adults are at increased risk of diabetes, hypertension, stroke and even some cancers.
Obesity ranges from mild (20 to 50 pounds overweight) to morbidly obese (more than 100 pounds overweight). Bariatric surgeries are usually reserved for those more than 100 pounds overweight.
This latest study reviewed 25,428 bariatric procedures involving Medicare beneficiaries using the National Inpatient Survey database, which contains discharge information for 20 percent of all hospitalizations in the United States, a sufficiently large enough population to overcome limitations of previous studies.
UT Southwestern is one of the few institutions in the nation that offers all types of bariatric procedures and is a regional referral center and leader in bariatric surgery, having performed the area's first lap band procedures and robotically assisted lap band procedures. UT Southwestern bariatrics programs have garnered national recognition as well, being named bariatric surgery Centers of Excellence by the American Society for Bariatric Surgery and United Resource Networks' Clinical Sciences Institute.
UT Southwestern Medical Center
In addition to age, the study found that men and those with electrolyte disorders and congestive heart failure were at greater risk of death from bariatric surgery or related complications, said Dr. Livingston.
Other conditions that increased risk for adverse events and required longer hospital stays included chronic pulmonary disease, diabetes and depression.
Common complications included gastrointestinal, respiratory and cardiac problems. Gastrointestinal problems were most common, occurring in about 30 percent of older patients who had complications. Respiratory-tract problems occurred in about 20 percent of patients with post-operative problems. Cardiac complications affected about 15 percent of elderly patients.
The Centers for Disease Control and Prevention estimates that nearly one-third of adult Americans - more than 60 million people - are obese. Nearly 5 percent of adults are classified as extremely obese. The American Society for Bariatric Surgery Foundation estimates that more than 1,000 people die each day from obesity-related complications. Obese adults are at increased risk of diabetes, hypertension, stroke and even some cancers.
Obesity ranges from mild (20 to 50 pounds overweight) to morbidly obese (more than 100 pounds overweight). Bariatric surgeries are usually reserved for those more than 100 pounds overweight.
This latest study reviewed 25,428 bariatric procedures involving Medicare beneficiaries using the National Inpatient Survey database, which contains discharge information for 20 percent of all hospitalizations in the United States, a sufficiently large enough population to overcome limitations of previous studies.
UT Southwestern is one of the few institutions in the nation that offers all types of bariatric procedures and is a regional referral center and leader in bariatric surgery, having performed the area's first lap band procedures and robotically assisted lap band procedures. UT Southwestern bariatrics programs have garnered national recognition as well, being named bariatric surgery Centers of Excellence by the American Society for Bariatric Surgery and United Resource Networks' Clinical Sciences Institute.
UT Southwestern Medical Center
Bariatric Surgery Current Events and Bariatric Surgery News RSSDiabetes surgery summit consensus lays foundation for new field of medicine
A first-of-its-kind consensus statement on diabetes surgery is published online today in the Annals of Surgery.
Energy gap useful tool for successful weight loss maintenance strategy
Americans continue to get heavier. Most weight control methods short of bariatric surgery are generally considered ineffective in preventing obesity or reducing weight.
Addressing obesity via the 'energy gap'
The November issue of the Journal of the American Dietetic Association features a commentary by James O. Hill, an honorary ADA member, professor of pediatrics and medicine and director of the Center for Human Nutrition at the University of Colorado-Denver.
'Superobesity,' chronic disease burden associated with risk of death following bariatric surgery
Veterans classified as superobese and those with a higher chronic disease burden appear more likely to die within a year of having bariatric surgery, according to a report in the October issue of Archives of Surgery, one of the JAMA/Archives journals.
NIH study finds low short-term risks after bariatric surgery for extreme obesity
Short-term complications and death rates were low following bariatric surgery to limit the amount of food that can enter the stomach, decrease absorption of food or both, according to the Longitudinal Assessment of Bariatric Surgery (LABS-1).
Study: Bariatric surgery patients have 67 percent lower chance of complications at top hospitals
The HealthGrades Fourth Annual Bariatric Surgery Trends in American Hospitals Study released today identifies 88 hospitals as "best" performers (five-star rated), with mortality rates, complication rates and patient lengths of stay that are dramatically lower than poorly rated hospitals.
A simpler definition for major depressive disorder
Researchers from Rhode Island Hospital's department of psychiatry propose that the definition for major depressive disorder (MDD) should be shortened to include only the mood and cognitive symptoms that have been part of the definition in the Diagnostic and Statistical Manual of Mental Disorders (DSM) for the past 35 years.
Roux-en-Y weight loss surgery raises kidney stone risk
The most popular type of gastric bypass surgery appears to nearly double the chance that a patient will develop kidney stones, despite earlier assumptions that it would not, Johns Hopkins doctors report in a new study.
Physiological response may explain why some severely obese patients overeat
Don't feel like you are getting full when eating a large meal? New research from The Miriam Hospital suggests that a physiological response may partially explain why severely obese individuals may not feel satisfied after eating and often have difficulty controlling the amount of food they consume during a meal.
Waiting times too long for bariatric surgery
Obesity is now acknowledged as a chronic disease with a number of related complications, and its prevalence has reached alarming epidemic proportions.
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