Department of Bariatric Surgery, Hamad General Hospital, Doha, Qatar.
HMC, P.O. Box: 3050, Doha, Qatar.
Obes Surg. 2018 Sep;28(9):2603-2608. doi: 10.1007/s11695-018-3221-0.
Obesity affects the elderly, leading to increased prevalence of age- and obesity-associated comorbidities. There are no guidelines for indications and risk assessment for the elderly undergoing bariatric surgery.
To determine the incidence, indications, and outcomes of planned ICU admission in elderly, high-risk patients after laparoscopic sleeve gastrectomy (LSG) and to assess if preoperative risk factors for planned postoperative ICU admission in elderly patients undergoing LSG could be predicted preoperatively.
Retrospective review of prospectively collected data for all patients aged ≥ 60 years who underwent LSG (2011-2016) at Hamad General Hospital in Qatar.
We followed up 58 patients aged 60-75 years for 28 ± 17 months. About 77.6% of patients were in the intermediate-risk group of the Obesity Surgery Mortality Risk Score (OS-MRS). Fourteen patients (24%) required ICU admission for 2 ± 1.2 days; all patients belonged to the American Society of Anesthesiologists (ASA) III class and intermediate to high risk on OS-MRS. There were no reported mortalities. The mean body mass index (BMI) decreased from 49 ± 10.6 to 37.6 ± 10.1 kg/m. The number of patient comorbidities (OR, 1.43; 95% CI, 1.03-1.99) and the diagnosis of obstructive sleep apnea (OSA; OR, 7.8; 95% CI, 1.92-31.68) were associated with planned ICU admission.
Elderly patients undergoing LSG usually have excellent postoperative course despite the associated high risk and the required ICU admission. The number of comorbidities, diagnosis of OSA, and ASA score are possible clinically significant predictive factors for the need of post-LSG ICU admission.
肥胖影响老年人，导致与年龄和肥胖相关的合并症患病率增加。对于接受减重手术的老年人，没有关于适应证和风险评估的指南。
确定腹腔镜袖状胃切除术（LSG）后，高龄高危患者计划入住 ICU 的发生率、适应证和结果，并评估高龄患者接受 LSG 后计划术后 ICU 入住的术前危险因素是否可以术前预测。
回顾性分析 2011 年至 2016 年在卡塔尔哈马德总医院接受 LSG 的所有年龄≥60 岁患者的前瞻性收集数据。
我们随访了 58 名年龄在 60-75 岁的患者，随访时间为 28±17 个月。约 77.6%的患者处于肥胖手术死亡率风险评分（OS-MRS）的中危组。14 名患者（24%）需要 ICU 入住 2±1.2 天；所有患者均属于美国麻醉医师协会（ASA）III 级，OS-MRS 中危至高危。无报告死亡。平均体重指数（BMI）从 49±10.6 降至 37.6±10.1 kg/m。患者合并症的数量（OR，1.43；95%CI，1.03-1.99）和阻塞性睡眠呼吸暂停（OSA；OR，7.8；95%CI，1.92-31.68）的诊断与计划 ICU 入院相关。
尽管相关风险较高且需要 ICU 入住，但接受 LSG 的老年患者术后通常有较好的病程。合并症的数量、OSA 的诊断和 ASA 评分是预测 LSG 后 ICU 入住需求的可能具有临床意义的预测因素。
