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Background <p>Bariatric surgery is an effective treatment for obesity and its associated comorbidities. However, the safety and efficacy of laparoscopic sleeve gastrectomy (LSG) for elderly and frail populations remain uncertain.</p> Objectives <p>To validate the efficacy and safety of LSG for elderly and frail patients and to assess its impact on overweight and obesity-related comorbidities.</p> Methods <p>A retrospective cohort study of patients undergoing LSG at a university-affiliated single center between 2009 and 2022 from a prospectively maintained database. Patients were categorized into two cohorts based on age and frailty index: elderly vs younger patients and frail vs non-frail groups. Preoperative, perioperative, and postoperative data were analyzed.</p> Results <p>Frailty was associated with statistically significantly higher perioperative complications (%, Clavien-Dindo of III/IV, 8 vs 3) and lower treatment success rates (% Excess Body Weight Loss, six-month, year, and two-year, 58 vs 64, 73 vs 82, 72 vs 81, and 63 vs 76, respectively). Age was not shown to alter the safety or efficacy of the operation.</p> Conclusion <p>While LSG is a viable option for elderly and frail patients, frailty is a significant predictor of treatment outcomes. A comprehensive assessment of individual factors, including frailty status, is essential for informed decision-making before surgery.</p>

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Frailty Index as a Predictor of Operative Safety and Efficacy in Patients Undergoing Laparoscopic Sleeve Gastrectomy

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年3月18日

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  • Eliahu Yonathan Bekhor,
  • Boris Kirshtein,
  • Noam Peleg,
  • Nayyera Tibi,
  • Hila Shmilovich,
  • Lisa Cooper,
  • Alex Tatarov,
  • Nidal Issa

摘要

Background

Bariatric surgery is an effective treatment for obesity and its associated comorbidities. However, the safety and efficacy of laparoscopic sleeve gastrectomy (LSG) for elderly and frail populations remain uncertain.

Objectives

To validate the efficacy and safety of LSG for elderly and frail patients and to assess its impact on overweight and obesity-related comorbidities.

Methods

A retrospective cohort study of patients undergoing LSG at a university-affiliated single center between 2009 and 2022 from a prospectively maintained database. Patients were categorized into two cohorts based on age and frailty index: elderly vs younger patients and frail vs non-frail groups. Preoperative, perioperative, and postoperative data were analyzed.

Results

Frailty was associated with statistically significantly higher perioperative complications (%, Clavien-Dindo of III/IV, 8 vs 3) and lower treatment success rates (% Excess Body Weight Loss, six-month, year, and two-year, 58 vs 64, 73 vs 82, 72 vs 81, and 63 vs 76, respectively). Age was not shown to alter the safety or efficacy of the operation.

Conclusion

While LSG is a viable option for elderly and frail patients, frailty is a significant predictor of treatment outcomes. A comprehensive assessment of individual factors, including frailty status, is essential for informed decision-making before surgery.