In 2001, the prevalence of obesity in the United States reached 26 %, more than double the rate in 1990.
Dr Hawn and colleagues determined the impact of the obesity epidemic on workload for general surgeons.
The researchers conducted a study that focused on the impact of obesity on surgical practice and resource utilization.
The research team conducted a retrospective analysis on patients undergoing cholecystectomy, unilateral mastectomy, and colectomy from 2000 to 2003 at a tertiary care center.
The main outcome variables were operative time, length of stay, and complications.
|Obese patient had longer operative time with respect to cholecystectomy|
|Annals of Surgery|
The researchers’ key independent variable was body mass index.
The investigators analyzed the association of obesity status with operative time, length of stay and complications for each surgery.
Multivariate regression models were used to control for surgeon time invariant characteristics.
The research team reported that there were 623 cholecystectomies, 322 unilateral mastectomies, and 430 colectomies suitable for analysis from 2000 to 2003.
Multivariable regression analyses indicated that obese patients had statistically significantly longer operative time but not longer length of stay or more complications.
The investigators found that when compared with a normal weight patient, an obese patient had an additional 5, 24 and 21 minutes of operative time with respect to cholecystectomy, unilateral mastectomy, and colectomy, respectively.
These estimates were robust in sensitivity analyses.
Dr Hawn concludes, “Obesity significantly increased operative time for each procedure studied.”
“These data have implications for health policy and surgical resource utilization.”
“We suggest that a CPT modifier to appropriately reimburse surgeons caring for obese patients be considered.”