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To determine whether obesity status is associated with perioperative complications, discharge outcomes and hospital length of stay in older surgical patients. Secondary analysis of five independent study cohorts (N=1262). An academic medical center between 2001 and 2017 in the United States. Patients aged 65years or older who were scheduled to undergo elective spine, knee, or hip surgery with an expected hospital stay of at least 2days. Body mass index (BMI) was stratified as nonobese (BMI≤30kg/m ), obesity class 1 (30kg/m ≤BMI35kg/m )