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Young adults are generally thought to be the least risky operative candidates for elective surgery, whereas older individuals may be considered too risky. In this issue of JAMA Surgery, Davidson et al1 challenge these notions for patients undergoing gastric bypass surgery.
At least 1 recent study2 in patients undergoing bariatric surgery has identified older age as a risk factor for poor outcome. These data combined with the belief that older patients may die before any health benefits of weight loss surgery are realized have led to physician reluctance to offer bariatric surgery to this population. However, Davidson et al1 report a hazard ratio of only 0.34, indicating a 66% reduction in mortality for the 65- through 74-year-old patients who have undergone gastric bypass surgery compared with their obese counterparts who have not undergone gastric bypass surgery. This finding is a powerful argument for keeping bariatric surgery in the armamentarium for treating obesity in older individuals.
Robinson MK. Expanding Our Understanding of Age-Related Mortality After Gastric Bypass Surgery. JAMA Surg. 2016;151(7):638. doi:10.1001/jamasurg.2015.5553