• Nesreen Khidir, Moamena El-Matbouly, Mohammed Al Kuwari, Michel Gagner, and Moataz Bashah.
• Department of Bariatric Surgery, Hamad General Hospital, Doha, Qatar. Dr_sora4@hotmail.com.
• Obes Surg. 2018 Sep 1; 28 (9): 2603-2608.

BackgroundObesity 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.ObjectivesTo 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.MethodsRetrospective review of prospectively collected data for all patients aged ≥ 60 years who underwent LSG (2011-2016) at Hamad General Hospital in Qatar.ResultsWe 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/m2. 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.ConclusionElderly 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.

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