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

IF 2.9 3区医学 Q1 SURGERY

Obesity Surgery Pub Date : 2025-03-18 DOI:10.1007/s11695-025-07713-y

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

{"title":"Frailty Index as a Predictor of Operative Safety and Efficacy in Patients Undergoing Laparoscopic Sleeve Gastrectomy.","authors":"Eliahu Yonathan Bekhor, Boris Kirshtein, Noam Peleg, Nayyera Tibi, Hila Shmilovich, Lisa Cooper, Alex Tatarov, Nidal Issa","doi":"10.1007/s11695-025-07713-y","DOIUrl":null,"url":null,"abstract":"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.","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":""},"PeriodicalIF":2.9000,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Obesity Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s11695-025-07713-y","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"SURGERY","Score":null,"Total":0}

引用次数: 0

Abstract

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.

查看原文本刊更多论文

虚弱指数作为腹腔镜袖式胃切除术患者手术安全性和有效性的预测指标。

背景：减肥手术是治疗肥胖及其相关合并症的有效方法。然而，腹腔镜袖胃切除术（LSG）对老年人和体弱人群的安全性和有效性仍不确定。目的：验证LSG对老年人和体弱患者的有效性和安全性，并评估其对超重和肥胖相关合并症的影响。方法：对2009年至2022年间在某大学附属单一中心接受LSG治疗的患者进行回顾性队列研究，这些患者来自前瞻性维护的数据库。患者根据年龄和虚弱指数分为两组：老年与年轻患者，虚弱与非虚弱组。分析术前、围手术期和术后数据。结果：虚弱与较高的围手术期并发症（%，Clavien-Dindo III/IV组，8 vs 3）和较低的治疗成功率（超重体重减轻%，6个月、1年和2年，分别为58 vs 64、73 vs 82、72 vs 81和63 vs 76）相关。年龄不会影响手术的安全性和有效性。结论：虽然LSG是老年人和体弱患者的可行选择，但虚弱是治疗结果的重要预测因素。对个人因素的全面评估，包括虚弱状态，对于在手术前做出明智的决策至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Obesity Surgery 医学-外科

CiteScore

5.80

自引率

24.10%

发文量

567

审稿时长

3-6 weeks

期刊介绍： Obesity Surgery is the official journal of the International Federation for the Surgery of Obesity and metabolic disorders (IFSO). A journal for bariatric/metabolic surgeons, Obesity Surgery provides an international, interdisciplinary forum for communicating the latest research, surgical and laparoscopic techniques, for treatment of massive obesity and metabolic disorders. Topics covered include original research, clinical reports, current status, guidelines, historical notes, invited commentaries, letters to the editor, medicolegal issues, meeting abstracts, modern surgery/technical innovations, new concepts, reviews, scholarly presentations and opinions. Obesity Surgery benefits surgeons performing obesity/metabolic surgery, general surgeons and surgical residents, endoscopists, anesthetists, support staff, nurses, dietitians, psychiatrists, psychologists, plastic surgeons, internists including endocrinologists and diabetologists, nutritional scientists, and those dealing with eating disorders.