Safe For Selected Older Patients

Peter T. Hallowell, M.D., and colleagues of University Hospitals Case Medical Center and Case Western Reserve University School of Medicine, Cleveland, reviewed the cases of 892 patients who had gastric bypass surgery from 1998 to 2006.

The patients were divided into four groups. Group one, 46 patients age 60 to 66 years was compared with group two, 846 patients age 18 to 59 years. Group three, 31 Medicare recipients (age 31 to 66), was compared with group four, 861 non-Medicare recipients (age 18 to 64). The age, sex and body mass index of each patient were documented as well as time spent in the operating room, length of stay, other illnesses and complications (including death).

When comparing older and younger patients, male-female ratios and Body-Mass-Indexes (BMI) were similar and length of stay was a half-day longer for group one. The older group spent an average of 17 minutes less in the operating room than the younger group. There was no statistically significant difference found between the two groups for any postoperative complication or death.

“No mortality was seen in the older group at 30 days, 90 days or one year. Three deaths occurred within 30 days in the younger group with one additional death within one year,” the authors of the study note.

When comparing Medicare and non-Medicare patients, group three (Medicare patients) had a greater average BMI of 56 and spent an average of 14 minutes longer in the operating room. Medicare patients also spent an average of a day-and-a-half longer in the hospital.

There was no significant difference between the two groups for any complication or death after surgery. No Medicare patients died at 30 days, 90 days or one year. Three non-Medicare patients died within 30 days and one additional patient died within one year.; Source: JAMA and Archives Journals