T. Hassinger1, J. Mehaffey1, L. Johnston1, G. Fasen1, B. Schirmer1, P. T. Hallowell1 1University Of Virginia,Department Of Surgery,Charlottesville, VIRGINIA, USA
Introduction: Numerous studies have established the effectiveness of Roux-en-Y Gastric Bypass (RYGB) for weight loss and comorbidity amelioration. This study evaluated outcomes in patients over the age of 60 with a propensity-matched group of controls. We hypothesized RYGB provides weight-loss benefits with no difference in overall survival.
Methods: All patients over the age of 60 undergoing RYGB at a single institution over a 30-year study period (1985-2015) were evaluated. Using a clinical data repository of all routine outpatient visits at our large academic medical center, we matched patients 4:1 on comorbidities, age, date of visit, and BMI to create our control population. Univariate analysis was performed, and Kaplan Meier survival curves were fitted for the two groups based on social security death data.
Results: Over the past 10 years 107 patients over the age of 60 underwent RYGB, and these were propensity matched with 428 controls. There was no difference in median BMI (45.6±5.3 vs. 47.1±4.3; p=0.45), age (61.6±2.1 vs. 62±2.0; p=0.15), or any other medical comorbidities between the groups. Kaplan Meier survival analysis with Log-Rank test demonstrated no difference in long-term survival (p=0.63) as seen below in Figure 1. Additionally, current BMI was evaluated based on medical record review demonstrating a significant percent excess BMI (%EBMI) reduction for the surgery group compared to the control group (81.8±35.8 vs. 10.3±28.0, p<0.001).
Conclusion: RYGB remains an excellent operation for weight reduction in patients over the age of 60 with no difference in long-term survival among comorbidity-matched controls. This study demonstrates major weight reduction benefit with surgery compared to an age- and comorbidity-matched control group. These data help to more clearly define the role for bariatric surgery in the elderly population and demonstrate outstanding %EBMI reduction.
