Trends in bariatric surgery from 2008 to 2012

Khan, Samiullah; Rock, Kathryn; Baskara, Arunkumar; Qu, Weikai; Nazzal, Munier; Ortíz, Jorge

doi:10.1016/j.amjsurg.2015.10.012

Cited by 99 publications

(72 citation statements)

References 43 publications

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“…According to an analysis based on the Nationwide Inpatient Sample database, the number of bariatric surgeries performed in the US from 2008-2012 was estimated at 598,576 8 . Bariatric surgery techniques have evolved over the last decade, and nearly all surgeries are currently performed using the minimally invasive laparoscopic approach, which is associated with shorter hospital stays and lower complication rates than the open approach [8][9][10] .…”

Section: Introductionmentioning

confidence: 99%

Comparison of economic and clinical outcomes between patients undergoing laparoscopic bariatric surgery with powered versus manual endoscopic surgical staplers

Roy¹,

Yoo

Yadalam

et al. 2017

Journal of Medical Economics

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Aims: To compare economic and clinical outcomes between patients undergoing laparoscopic Rouxen-Y gastric bypass (LRY) or laparoscopic sleeve gastrectomy (LSG) with use of powered vs manual endoscopic surgical staplers. Materials and methods: Patients (aged !21 years) who underwent LRY or LSG during a hospital admission (January 1, 2012-September 30, 2015 were identified from the Premier Perspective Hospital Database. Use of powered vs manual staplers was identified from hospital administrative billing records. Multivariable analyses were used to compare the following outcomes between the powered and manual stapler groups, adjusting for patient and hospital characteristics and hospital-level clustering: hospital length of stay (LOS), total hospital costs, medical/surgical supply costs, room and board costs, operating room costs, operating room time, discharge status, bleeding/transfusion during the hospital admission, and 30, 60, and 90-day all-cause readmissions. Results: The powered and manual stapler groups comprised 9,851 patients (mean age ¼ 44.6 years; 79.3% female) and 21,558 patients (mean age ¼ 45.0 years; 78.0% female), respectively. In the multivariable analyses, adjusted mean hospital LOS was 2.1 days for both the powered and manual stapler groups (p ¼ .981). Adjusted mean total hospital costs ($12,415 vs $13,547, p ¼ .003), adjusted mean supply costs ($4,629 vs $5,217, p ¼ .011), and adjusted mean operating room costs ($4,126 vs $4,413, p ¼ .009) were significantly lower in the powered vs manual stapler group. The adjusted rate of bleeding and/or transfusion during the hospital admission (2.46% vs 3.22%, p ¼ .025) was significantly lower in the powered vs manual stapler group. The adjusted rates of 30, 60, and 90-day all-cause readmissions were similar between the groups (all p > .05). Sub-analysis by manufacturer showed similar results. Limitations: This observational study cannot establish causal linkages. Conclusions: In this analysis of patients who underwent LRY or LSG, the use of powered staplers was associated with better economic outcomes, and a lower rate of bleeding/transfusion vs manual staplers in the real-world setting.ARTICLE HISTORY

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Section: Introductionmentioning

confidence: 99%

Comparison of economic and clinical outcomes between patients undergoing laparoscopic bariatric surgery with powered versus manual endoscopic surgical staplers

Roy¹,

Yoo

Yadalam

et al. 2017

Journal of Medical Economics

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“…In a review of hospital charges for bariatric procedures, Livingston reported a median fee of $22,000 [28,29]. Laparoscopic gastric sleeve is now the most commonly utilized bariatric procedure [30]. Hyperoxaluria is less of a problem in this procedure.…”

Section: Transplantation After Donor Bariatric Surgerymentioning

confidence: 99%

“…Many guidelines discourage donation by living donors with a BMI >35 kg/m 2 [30][31][32][33]. This is because of risks to both the recipient and the donor.…”

Section: Transplantation With An Obese Live Donor Kidneymentioning

confidence: 99%

Bariatric surgery for obese live kidney donors: an analysis of risks and benefits

Brooks¹,

Mitro²,

DeLeonibus³

et al. 2017

Integr Obesity Diabetes

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Background: Obesity can be a barrier to live donor selection and there are reports of obese live kidney donors (OLKDs) undergoing bariatric surgery prior to donation. While this practice has potential promise, the risks associated with it are unclear. Thus, our aim was to evaluate the advantages and disadvantages of this practice.Design: Risks and benefits were ascertained from the literature. Analysis of costs and benefits was performed to provide objective data for each scenario.Results: Live kidney donation is associated with superior outcomes compared to deceased donation. However, live donors are at risk of complications that could be exacerbated by obesity. Higher donor body mass index (BMI) has been associated with inferior recipient outcomes. Bariatric surgery (BS) results in decreased mortality and can induce sustained weight loss. Our cost-benefit analysis revealed a benefit-to-cost ratio of 3.64 for BS prior to live donation by OLKDs. We found ratios of 3.19 and 0.97 for live donation with an obese donor and a deceased donor, respectively. Conclusions:Our results suggest that BS for an OLKD has the potential to increase the number of live donors and improve outcomes. However, more data is required; thus we recommend a registry of patients who have undergone both procedures.

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“…[9]Bariatric surgery techniques have evolved over the last decade and the majority are performed using the laparoscopic approach, which is associated with shorter hospital stays and lower complication rates than open gastric bypass. [8,10,11] Results of a large observational study, conducted by Weiner et al, of 29,820 plan members who underwent bariatric surgery between 2002 and 2008 indicated that bariatric surgery is associated with a reduction in overall healthcare costs in the first years following surgery; however, the savings in healthcare costs of patients who underwent surgery versus those of non-surgery controls did not persist. [12]Although costs for pharmacy and outpatient visits did remain reduced among surgery patients versus controls up to 6 years post-surgery in that study, inpatient services were higher and offset the savings.…”

mentioning

confidence: 99%

“…[7] Using the Nationwide Inpatient Sample database, the number of bariatric surgeries performed in the U.S. from 2008 to 2012 was estimated at 598,576, with a rate in 2012 of51 surgeries per 100,000 people. [8]Current guidelines of the American Association of Clinical Endocrinologists, The Obesity Society, and the ASMBS recommend that persons with severe obesity (≥40 kg/m 2 ) without coexisting medical problems and persons with a BMI ≥35kg/m 2 and at least one obesity related co morbidity (e.g. T2DM, dyslipidemia, hypertension) be considered eligible for bariatric surgery.…”

mentioning

confidence: 99%

Assessing Real World Effect of Laparoscopic Bariatric Surgery on Healthcare Costs- a Retrospective Matched Cohort Study using a U.S. Administrative Claims Database

Dawson¹,

Bour²,

Yoo³

et al. 2016

JED

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Trends in bariatric surgery from 2008 to 2012

Cited by 99 publications

References 43 publications

Comparison of economic and clinical outcomes between patients undergoing laparoscopic bariatric surgery with powered versus manual endoscopic surgical staplers

Comparison of economic and clinical outcomes between patients undergoing laparoscopic bariatric surgery with powered versus manual endoscopic surgical staplers

Bariatric surgery for obese live kidney donors: an analysis of risks and benefits

Assessing Real World Effect of Laparoscopic Bariatric Surgery on Healthcare Costs- a Retrospective Matched Cohort Study using a U.S. Administrative Claims Database

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