complications in the United States declined 21 percent between 2001 and
2006, and payments to hospitals for obesity surgery decreased by as much
as 13 percent, partly because there were fewer patient readmissions due to
complications, a new study reports.
The findings from a study by the U.S. Agency for Healthcare Research
and Quality are based on an analysis of more than 9,500 patients under age
65 who had obesity surgery, also known as bariatric surgery, at 652
hospitals between 2001 and 2002 and between 2005 and 2006.
The researchers found that the complication rate among obesity surgery
patients dropped from 24 percent to about 15 percent. Contributing to that
decrease were declines in post-surgical infection rates (58 percent
lower), abdominal hernias, staple leakage, respiratory failure and
pneumonia (29 percent to 50 percent lower).
There was little change in rates of other complications such as ulcers,
dumping (involuntary vomiting or defecation), hemorrhage, wound
re-opening, deep-vein thrombosis and pulmonary embolism, heart attack and
stroke, the researchers noted.
Between 2001 and 2006, hospital payments for obesity surgery as a whole
fell from $29,563 to $27,905. Payments for patients who experienced
complications declined from $41,807 to $38,175, and from $80,001 to
$69,960 for those who had to be readmitted to hospital because of
complications, according to the study in the May issue of the journal
Medical Care.
Among the other findings:
Complications fell even though there were more older and sicker
patients having obesity surgery. During the study period, the proportion
of patients over age 50 having obesity surgery increased from 28 percent
to 44 percent, and the average number of underlying illnesses � such as
diabetes, high blood pressure and sleep apnea � in bariatric surgery
patients more than doubled.
The six-month post-surgical death rate remained at about 0.5 percent
during the study period.
Hospital readmissions due to complications fell from 10 percent to 7
percent, and complication-caused, same-day hospital outpatient visits fell
from 15 percent to 13 percent.
The researchers said three main factors are behind the decline in
complications and costs among obesity surgery patients: increased use of
laparoscopy, which allows surgeons to operate through small incisions;
increased use of banding procedures without gastric bypass, such as
vertical-banded gastroplasty and lap band; and increased surgeon
experience.
More information
The U.S. National Institute of Diabetes and Digestive and Kidney
Diseases has more about bariatric surgery.
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