Background

As the geriatric population grows, more patients will be eligible for metabolic and bariatric surgery (MBS), which challenges the definition of geriatrics beyond age 65. Published scoring systems such as bariatric fragility scores (BFS, scores >5=high risk) and GeriBari (GB, score >14=high risk) scores can aid in predicting the risk of serious postoperative complications. This abstract presents the largest single-center outcomes of MBS in patients aged >= 70.

Methods

A single-center retrospective cohort study 2012-2022, patients ages >= 70 underwent laparoscopic sleeve gastrectomy (LSG) or roux-en-y gastric bypass (LRYGB). Outcomes compared to our center's extrapolated cohort of MBS patients aged 45-65.

Results

130 patients, mean age 72.1 (range 70-80), 63% female, BMI 42.9 (SD 5.76), and 65% underwent LSG. Compared to a cohort of 3665 patients age 45-65, the length of stay average of 1.9 days (SD 1.9) vs. 1.4 (SD 1.38) (p=0.001), overall 30-day readmission rate of 5.4% vs. 5.7% (p = 0.439), reoperation rate of 3.1% vs. 2.7% (p = 0.406), and overall complication rate 9.2% vs. 5.9% (p= 0.056) with one 30-day mortality due to unknown causes. LRYGB vs. LSG patients had a higher reoperation rate (8.7% vs 0.0%, p=0.003) and complication rate (17.4% vs 4.8%, p = 0.009). High-risk BFS and GB scores (p = 0.014, p = 0.026) were associated with 30-day postoperative complications.

Conclusions

MBS in septuagenarians and octogenarians had safer outcomes undergoing LSG than RYGB. BFS and GB scores deeming patients high risk were associated with a higher 30-day postoperative complication rate.