Incidence, Indications, and Predictive Factors for ICU Admission in Elderly, High-Risk Patients Undergoing Laparoscopic Sleeve Gastrectomy

Background 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. Objectives To determine the incidence, indications, and outcomes of planned...

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Bibliographic Details
Published in:Obesity surgery 2018-09, Vol.28 (9), p.2603-2608
Main Authors: Khidir, Nesreen, EL-Matbouly, Moamena, Al Kuwari, Mohammed, Gagner, Michel, Bashah, Moataz
Format: Article
Language:English
Subjects:
Gastrointestinal surgery
Laparoscopy
Medicine
Medicine & Public Health
Obesity
Original Contributions
Patient admissions
Sleep apnea
Surgery
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Summary:Background 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. Objectives 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. Methods Retrospective review of prospectively collected data for all patients aged ≥ 60 years who underwent LSG (2011–2016) at Hamad General Hospital in Qatar. Results 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 2 . 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. Conclusion 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.
ISSN:0960-8923
1708-0428
DOI:10.1007/s11695-018-3221-0