Time Attributable to Obesity in Surgery: A Multi-specialty Report on Day-of-Surgery Resource Utilization from 189,264 Cases
- 64 Downloads
Obesity presents a unique challenge in caring for surgical patients and has been shown to adversely affect outcomes for several operative procedures. However, quantitative data on surgical resource utilization attributable to obesity are scarce. The aim of this study was to quantify day-of-surgery resource utilization by degree of obesity.
Patients undergoing one of 14 common surgical procedures at our multicenter institution between 2008 and 2017 were identified from our operating room management databank. Multiple-variable regression analysis (MVRA) was performed to quantify the independent effect of body mass index (BMI) category on day-of-surgery resource utilization variables including procedure time, non-operative OR time, PACU time, number of unique staff and number of supplies used. Trends in mean BMI were examined for each procedure studied.
MVRA of the 189,264 cases in the database revealed consistently significant (p < 0.05) stepwise increase in procedure time by BMI category for all procedures studied. Non-operative OR time was also significantly prolonged, though to a lesser degree. There was no significant impact on number of unique staff, supplies utilized or PACU time by BMI category. Procedures most impacted by BMI category in terms of resource utilization were ventral hernia repair, laminectomy and hysterectomy.
Our study quantified day-of-surgery resource utilization for 14 major surgical procedures by BMI category. The need for additional resources to accommodate patients in higher BMI groups was consistent across all procedures studied and was primarily reflected by lengthened operative times.
- 2.Abarca-Gómez L, Abdeen ZA, Hamid ZA et al (2017) Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016: a pooled analysis of 2416 population-based measurement studies in 128 9 million children, adolescents, and adults. Lancet. https://doi.org/10.1016/s0140-6736(17)32129-3 CrossRefGoogle Scholar
- 3.Haslam DW, James WPT. Obesity. In: Lancet. 2005. Epub ahead of print 2005. https://doi.org/10.1016/s0140-6736(05)67483-1
- 8.Sood A, Firas Abdollah B, Jesse Sammon BD et al (2015) The effect of body mass index on perioperative outcomes after major surgery: results from the national surgical quality improvement program (ACS-NSQIP) 2005–2011. World J Surg 39:2376–2385. https://doi.org/10.1007/s00268-015-3112-7 CrossRefPubMedGoogle Scholar
- 10.HCUP-US tools and software page CCS-services and procedures. https://www.hcup-us.ahrq.gov/toolssoftware/ccs_svcsproc/ccssvcproc.jsp. Accessed 16 Oct 2017
- 11.World Health Organization (2000) Obesity: preventing and managing the global epidemic: report of a WHO consultation. World Health OrganizationGoogle Scholar
- 15.Sun SX, Greenleaf EK, Hollenbeak CS et al (2015) Attributable cost of obesity in breast surgery: a matched cohort analysis. Am J Surg 210(668–677):e1Google Scholar