April 29, 2009

Obesity Surgery Complications on the Decline

WEDNESDAY, April 29 (HealthDay News) -- Obesity surgery-related 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.

-- Robert Preidt
SOURCE: U.S. Agency for Healthcare Research and Quality, news release, April 29, 2009
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