Impact of body mass index on utilization of selected hospital resources for four common surgical procedures

Abstract

Background Evidence about the impact of obesity on surgical resource consumption in the Australian setting is equivocal. Our objectives were to quantify the prevalence of obesity in four frequently performed surgical procedures and explore the association between body mass index (BMI) and hospital resource utilization including procedural duration, length of stay (LOS) and costs. Methods A retrospective cohort study of patients undergoing four surgical procedures at a tertiary referral centre in New South Wales, between 1 January 2016 and 31 December 2016, was conducted. The four surgical procedures were total hip replacement, laparoscopic appendectomy, laparoscopic cholecystectomy and hysteroscopy with dilatation and curettage. Surgical groups were stratified according to BMI category. Results A total of 699 patients were included in the study. The prevalence of obesity was significantly higher than local and national population estimates for all procedures except appendectomy. BMI was not associated with increased hospital resource utilization (procedural, anaesthetic or intensive care stay duration) in any of the four surgical procedures examined after controlling for age, gender and complexity. For other outcomes of hospital resource utilization (LOS and cost), the relationship was inconsistent across the four procedures examined. A high BMI was positively associated with higher LOS, medical costs and allied health costs in those who underwent an appendectomy, and critical care costs in those who underwent laparoscopic cholecystectomy. Conclusion Obesity was common in patients undergoing four frequently performed surgical procedures. The relationship between BMI and hospital resource utilization appears to be complex and varies across the four procedures examined.

Body Mass Index Is Associated with the Severity and All‐Cause Mortality of Acute Kidney Injury in Critically Ill Patients: An Analysis of a Large Critical Care Database

“…More than half of American adults are overweight or obese, and this proportion is increasing [12,13]. Studies have shown that obesity is associated with an increased morbidity in cardiovascular disease, diabetes, and depression [14][15][16], increasing hospital length of stay and medical costs [17,18].…”

Surgical prehabilitation using mobile health coaching in patients with obesity: A pilot study

“…20 Participants with an elevated BMI have largely been excluded from or underrepresented in prehabilitation studies. [21][22][23][24] However, they comprise a large proportion of elective case waiting lists, particularly orthopaedic and gynaecology lists 25 and therefore the total surgical inpatient population. Although we did not measure postoperative outcomes, one prehabilitation programme focusing on weight reduction showed meaningful decreases in rates of surgical and cardiovascular complications postoperatively.…”

Preoperative communication between anaesthetists and patients with obesity regarding perioperative risks and weight management: a structured narrative review

“…Obesity is an increasingly common problem in many countries (Twells et al, 2014 ) with many potential health implications in the perioperative period (Nightingale et al, 2015 ). Rates of obesity in surgical patients have been reported to vary between 35 and 70% depending on the type of surgery and can be twice the background rate of the general population (Mullen et al, 2009 ; AIHW, 2019 ; STARSurg-Collaborative, 2016 ; Hamlin et al, 2013 ; Freckelton et al, 2019 ; Harms et al, 2007 ). Preoperative problems include optimisation of concurrent medical conditions such as obstructive sleep apnoea (Chung et al, 1999 ; Abdullah & Chung, 2014 ).…”