Metabolic and bariatric surgery (MBS) is increasingly performed in those greater than 65 years old. Studies have shown equivocal results regarding perioperative outcomes. Our study objective was to explore perioperative outcomes in elderly MBS patients compared to those < 65 years old.


Primary sleeve (SG) and gastric bypass (RnYGB) cases were identified from the 2015-2017 Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) database. Selected cases were stratified by age (≥ 65 years vs. < 65 years). Univariate and multivariate logistic regression analysis were performed comparing descriptive statistics and outcomes in elderly compared the general MBS cohort.


26,557 (5.6%) of MBS cases were performed in elderly patients. Elderly patients were more likely to be Caucasian, male, have a lower mean BMI, received a gastric bypass and robotic-assisted surgery. Elderly patients had a significantly higher disease burden (Table 1). All outcome measures were significantly higher (p < 0.05) in elderly patients (Table 1), including overall and related mortality and morbidity. Unlike Black race, BMI, heart disease, renal disease, venous thromboembolism, and gastric bypass procedure, age was not a significant predictor of adverse outcomes on multivariate logistic regression analysis (Wald 3.38, p = 0.07). The number needed to harm (NNH) for overall and related morbidity were 58 and 230, respectively.


Elderly MBS patients have higher disease burden and higher adverse outcomes following MBS; however, MBS in this cohort remains overall safe. Procedure consideration should favor SG as RnYGB was independently associated with worse outcomes.