Medical complications in 166,601 surgical patients with morbid obesity vary directly with increasing age independent of BMI

Abstract

Objective: To identify the incidence of obesity co-morbidities by age in patients with obesity. Methods: Pre-operative data on 166,601 patients from the Surgical Review Corporation’s BOLD database was analyzed by age. Data: demographics, BMI, and percent of 33 obesity co-morbidities. Statistics: ANOVA for continuous variables; Dichotomous variables by general linear models. Results: BMI and percent alcohol/tobacco/substance use, PCOS, mental health diagnosis, and pseudotumor cerebri varied inversely by age. Percent hernia, abdominal panniculitis, angina, cholelithiasis, CHF, DVT/PE, fibromyalgia, impaired function, GERD, diabetes, gout, hypertension, ischemic heart disease, dyslipidemia, leg edema, back pain, musculoskeletal pain, obesity hypoventilation, peripheral vascular disease, pulmonary hypertension, stress incontinence, and unemployment (n=23) increased directly with increasing age, peaking in the 60-70 and >70 years cohorts. Asthma, depression, psychologic impairment, and liver disease were highest in the 40-60 decades Conclusions: In patients with obesity, weight-related medical conditions vary dramatically by age. Younger patients had highest BMI and suffered most from alcohol/tobacco/substance abuse and psychological problems. The major weight-related cardiopulmonary, abdominal/hepatobiliary, endocrine/metabolic, and somatic issues increased progressively with each higher decade of age. This advance knowledge of obesity risks by age may raise clinical index of suspicion, possibly facilitating presumptive management of patients with obesity and improved outcomes.