This is the Scientific Surgery Archive, which contains all randomized clinical trials in surgery that have been identified by searching the top 50 English language medical journal issues since January 1998. Compiled by Jonothan J. Earnshaw, former Editor-in-Chief, BJS
Impact of obesity on the cost of major colorectal surgery. BJS 2013; 100: 293-298.
Published: 22nd November 2012
Authors: R. Tapper, L. Dixon, C. Frampton, F. Frizelle
Background
The incidence of obesity is increasing in New Zealand. The aim of the study was to determine whether obesity impacts on the cost of treating patients undergoing major colorectal surgery.
Method
Between 1 February 2008 and 31 July 2009, consecutive patients undergoing major colorectal surgery at Christchurch Hospital, New Zealand, were enrolled in the study. Body mass index (BMI) and waist‐to‐hip ratios were assessed using standardized techniques. Patients with a high surgical risk were identified using established criteria and all patients were assessed using the Portsmouth modification of the Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity (P‐POSSUM). Cost analysis was performed using a structured query language database. Patients were analysed using accepted groupings for BMI, waist circumference and waist‐to‐hip ratio.
Results
A total of 372 patients were enrolled in the study, of whom 345 were included in the analysis. The incidence of diabetes was significantly higher with increased BMI (P = 0·002), whereas all other co‐morbidities, and P‐POSSUM values, did not differ between BMI groups. The groups were similar in terms of case mix. Treatment of obese patients (BMI at least 30 kg/m2) was significantly more expensive than that of normal weight patients (BMI 20–24·9 kg/m2): €10 036 versus €7390 (P = 0·005). Treatment costs for patients with a BMI of 25–29·9 kg/m2 were next highest (€9048) followed by those for patients whose BMI was less than 20 kg/m2 (€8884). Patients with a waist circumference above recognized standards for men and women also cost significantly more to treat (€10 063 versus €7836; P = 0·014).
Conclusion
Excess body fat was associated with higher costs of major colorectal surgery. Copyright © 2012 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
Full textYou may also be interested in
Original article
Authors: S. Nougaret, F. Castan, H. Forges, H. A. Vargas, B. Gallix, S. Gourgou et al.
Original article
Authors: B. Garlipp, P. Gibbs, G. A. Van Hazel, R. Jeyarajah, R. C. G. Martin, C. J. Bruns et al.
Original article
Authors: R. Behman, A. B. Nathens, B. Haas, N. Look Hong, P. Pechlivanoglou, P. Karanicolas et al.
Original article
Authors: M. E. Stellingwerf, S. Sahami, D. C. Winter, S. T. Martin, G. R. D'Haens, G. Cullen et al.
Original article
Authors: D. Isacson, K. Smedh, M. Nikberg, A. Chabok
Original article
Authors: R. L. Venchiarutti, M. J. Solomon, C. E. Koh, J. M. Young, D. Steffens
Systematic review
Authors: S. J. Rottier, S. T. Dijk, A. A. W. Geloven, W. H. Schreurs, W. A. Draaisma, W. A. Enst et al.
Randomized clinical trial
Authors: S. Pucciarelli, P. Del Bianco, U. Pace, F. Bianco, A. Restivo, I. Maretto et al.
Review
Authors: T. O. Sillo, A. D. Beggs, D. G. Morton, G. Middleton
Systematic review
Authors: É. J. Ryan, D. P. O'Sullivan, M. E. Kelly, A. Z. Syed, P. C. Neary, P. R. O'Connell et al.
Randomized clinical trial
Authors: B. K. Bednarski, T. P. Nickerson, Y. N. You, C. A. Messick, B. Speer, V. Gottumukkala et al.
Original article
Authors: J. Erlandsson, D. Pettersson, B. Glimelius, T. Holm, A. Martling