New York/Los Angeles–Obesity is a worldwide concern that affects every population and tremendously increases healthcare costs. Degenerative spine disease is also a global burden that can lead to low back pain and disability. Obesity has been shown to cause spine degeneration and pain, often requiring obese patients to seek surgical treatment. The World Health Organization (WHO) reports that obesity -- one of the most preventable risk factors for a number of diseases -- has more than doubled since 1980. According to the WHO, in 2008 roughly 1.5 billion people aged 20 and older were overweight, with more than 200 million men and nearly 300 million women considered obese.
One of the largest studies to date has affirmed that the impact of obesity upon spine surgery management is much greater than previously thought, significantly increasing the amount of perioperative healthcare resources needed. Details of the study are provided in "The Impact of Obesity on Perioperative Resource Utilization after Elective Spine Surgery for Degenerative Disease" by Michelle Clarke, MD, et al., an article appearing in issue 4 of Global Spine Journal, the official journal of AOSpine, recently published by Thieme.
This article is a retrospective review of 3,270 consecutive non-instrumented decompressive surgeries at a single institution from 2005 and 2012 that compares resource utilization between non-obese and obese individuals. After correcting for baseline differences between groups, the authors identified several significant correlations. Obesity was associated with longer surgical and anesthesia times, higher ICU admission rates, an increased need for post-operative ventilation, and longer post-operative hospital stays. Overall, the obese patient is $1,632 more expensive to care for than a non-obese patient of similar health. During the study period, the cost attributable to obesity totaled over $2,300,000.
When asked about the importance of the paper’s results, corresponding author Michelle Clarke, MD commented:
“The results presented represent differences which exist despite a standardization of care for spinal procedures. Also, proprietary software developed by Mayo Clinic allows for a comprehensive analysis of resource utilization for every hospital visit and provides an adjusted value for each specific resource to account for differences in inflation and scarcity.”
Contributing author Ryan F. Planchard, MD, said:
“On a per patient level it is necessary to account for the noted differences when planning an elective procedure. Especially considering limited resources (e.g. hospital/ICU beds and surgical scheduling) it is prudent to consider the increased needs associated with obesity.”
Contributing author Grant W. Mallory, MD, also commented:
“For the health system at large, the results of this paper support revaluating hospital reimbursement in relation to a patient BMI. On the aggregate there are large differences in cost which depend on the composition of a provider’s patient population, and these differences need further examination to fairly compensate hospitals that preferentially take on these more challenging cases.”
This study is published in Global Spine Journal. Media wishing to receive a PDF of this article may contact the Publisher. For questions about the journal, please contact the editorial office.
About Global Spine Journal
Global Spine Journal, the official journal for AOSpine International is an international peer-reviewed journal devoted to the study of all spine fields. It is comprised of 6 issues per year. Two of these issues per year are special issues of Evidence-Based Spine-Care Journal. For more details, please visit https://aospine.aofoundation.org/Structure/community/AOSpine-Journals/Pages/AOSpine-Journals.aspx
AOSpine is an international community of spine surgeons generating, distributing, and exchanging knowledge to advance science and the spine care profession through research, education, and community development. With over 6,000 members spread across the globe, AOSpine continues to advance spine care worldwide.
Global Spine Journal is published by Thieme Publishers, an award-winning international medical and science publisher serving health professionals and students for more than 125 years. Thieme promotes the latest advancements in clinical practice, publishes the latest research findings, advocates medical education and is known for the high quality and didactic nature of its books, journals, and electronic products. For more information about Thieme, please visit www.thieme.com.
About the Authors
Ryan F. Planchard, BE (Co-first author): Department of Neurosurgery, Mayo Clinic Rochester, Rochester, Minnesota, United States
Dominique M. Higgins, MS (Co-first author): Department of Neurosurgery, Mayo Clinic Rochester, Rochester, Minnesota, United States
Grant W. Mallory, MD: Department of Neurosurgery, Mayo Clinic Rochester, Rochester, Minnesota, United States
Ross C. Puffer, MD: Department of Neurosurgery, Mayo Clinic Rochester, Rochester, Minnesota, United States
Jeffrey T. Jacob, MD: Department of Neurosurgery, Mayo Clinic Rochester, Rochester, Minnesota, United States
Timothy B. Curry, MD: Department of Anesthesiology, Mayo Clinic Rochester, Rochester, Minnesota, United States
Daryl J. Kor, MD: Department of Anesthesiology, Mayo Clinic Rochester, Rochester, Minnesota, United States
Michelle J. Clarke, MD (Corresponding author): Department of Neurosurgery, Mayo Clinic Rochester, Rochester, Minnesota, United States
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