Medical and financial risks associated with surgery in the elderly obese.

Annals of Surgery
Jeffrey H SilberLee A Fleisher

Abstract

To study the medical and financial outcomes associated with surgery in elderly obese patients and to ask if obesity itself influences outcomes above and beyond the effects from comorbidities that are known to be associated with obesity. Obesity is a surgical risk factor not present in Medicare's risk adjustment or payment algorithms, as BMI is not collected in administrative claims. A total of 2045 severely or morbidly obese patients (BMI ≥ 35 kg/m, aged between 65 and 80 years) selected from 15,914 elderly patients in 47 hospitals undergoing hip and knee surgery, colectomy, and thoracotomy were matched to 2 sets of 2045 nonobese patients (BMI = 20-30 kg/m). A "limited match" controlled for age, sex, race, procedure, and hospital. A "complete match" also controlled for 30 additional factors such as diabetes and admission clinical data from chart abstraction. Mean BMI in the obese patients was 40 kg/m compared with 26 kg/m in the nonobese. In the complete match, obese patients displayed increased odds of wound infection: OR (odds ratio) = 1.64 (95% CI: 1.21, 2.21); renal dysfunction: OR = 2.05 (1.39, 3.05); urinary tract infection: OR = 1.55 (1.24, 1.94); hypotension: OR = 1.38 (1.07, 1.80); respiratory events: OR = 1.44 (1.19, ...Continue Reading

References

Apr 1, 1986·Annals of Internal Medicine·P S PasulkaG L Blackburn
Mar 24, 1998·Annual Review of Medicine·L Flancbaum, P S Choban
Feb 24, 1999·JAMA : the Journal of the American Medical Association·M D NaylorJ S Schwartz
Jul 15, 1999·Journal of Surgical Oncology·L S Wilson, J M Lightwood
Sep 22, 2001·Medical Care·J H SilberR E Mosher
May 9, 2002·Surgical Endoscopy·A J PikarskyS D Wexner
Apr 25, 2003·The New England Journal of Medicine·Eugenia E CalleMichael J Thun
Jun 20, 2003·Lancet·Daniel DindoPierre-Alain Clavien
Feb 10, 2004·The Journal of Urology·Sam S ChangMichael S Cookson
Apr 17, 2004·Journal of the American Geriatrics Society·Mary D NaylorJ Sanford Schwartz
Sep 17, 2004·The Journal of Urology·Cheryl T LeeJames E Montie
Jan 19, 2005·Medical Care·Jeffrey H SilberOrit Even-Shoshan
Apr 28, 2005·Annals of Emergency Medicine·Anil BamezaiAmar Nawathe
Jun 24, 2005·Annals of Surgery·Jeffrey H SilberOrit Even-Shoshan
Oct 11, 2005·The Journal of Arthroplasty·Robert S NambaMary Lou Stone
Sep 8, 2006·World Journal of Surgery·Olumuyiwa A BamgbadePema Dorje
Apr 3, 2007·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Jeffrey H SilberThomas C Randall
Sep 6, 2007·JAMA : the Journal of the American Medical Association·Kevin G VolppJeffrey H Silber
Sep 6, 2007·JAMA : the Journal of the American Medical Association·Kevin G VolppJeffrey H Silber
Sep 28, 2007·Diseases of the Colon and Rectum·Kelly A GendallFrank A Frizelle
Sep 23, 2008·The American Journal of Nursing·Mary Naylor, Stacen A Keating
Feb 18, 2009·Archives of Surgery·Jeffrey H SilberKevin G Volpp
Feb 21, 2009·Journal of the American College of Surgeons·Ryan P MerkowDavid J Bentrem
Apr 3, 2009·The New England Journal of Medicine·Stephen F JencksEric A Coleman
Sep 26, 2009·Annals of Surgery·Raymond J LynchMichael J Englesbe
Feb 9, 2010·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Amit K MathurTheodore H Welling
Jul 2, 2011·Anesthesiology·Jeffrey H SilberLee A Fleisher
Aug 6, 2011·The Journal of Surgical Research·Linda I SuleimanTerrence M Fullum

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Citations

Mar 20, 2013·Best Practice & Research. Clinical Obstetrics & Gynaecology·Sarah HughesJoanna Cain
Oct 9, 2013·Clinical Orthopaedics and Related Research·Hilal Maradit KremersDavid G Lewallen
Feb 26, 2016·Journal of Shoulder and Elbow Surgery·Joseph M StatzJohn W Sperling
Oct 5, 2013·Journal of Shoulder and Elbow Surgery·Anil K GuptaGregory P Nicholson
Jun 15, 2013·The Journal of Surgical Research·Federico J YanquezAziz M Merchant
Mar 26, 2013·Journal of the American College of Surgeons·Michael J EnglesbeChristopher J Sonnenday
Mar 2, 2016·Health Services Research·Jeffrey H SilberLee A Fleisher
Aug 8, 2013·The Journal of Hospital Infection·R HuttunenJ Syrjänen
Sep 10, 2014·Health Services Research·Jeffrey H SilberLee A Fleisher
Jul 22, 2014·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·P P ReeseJ H Silber
Mar 5, 2014·Health Services Research·Jeffrey H SilberLee A Fleisher
Aug 21, 2013·The Journal of Arthroplasty·James M SaucedoLalit Puri
Jan 7, 2015·Clinical Orthopaedics and Related Research·David W ShearerKevin J Bozic
Nov 22, 2015·BJU International·Michael L BluteE Jason Abel
Dec 3, 2016·Surgical Infections·William J PeppardJohn A Weigelt
Feb 1, 2017·Gerontology & Geriatric Medicine·Shirley MusichCharlotte S Yeh
Mar 23, 2017·Journal of the American Society of Nephrology : JASN·Neel KoyawalaPeter P Reese
Oct 9, 2012·Current Opinion in Infectious Diseases·Brett Janson, Karin Thursky
Jul 4, 2019·Medical Care·Jeffrey H SilberOrit Even-Shoshan
Nov 23, 2013·Annals of Surgery·Laurent G GlanceAndrew W Dick
Mar 25, 2015·Obesity Surgery·Joseph A SanfordAlex Macario
May 20, 2016·Clinical & Translational Immunology·Md Nahidul IslamRhodri Ceredig
Nov 15, 2019·Annals of Surgery·Rachel R KelzJeffrey H Silber
May 31, 2013·Anesthesiology·Jeffrey H SilberLee A Fleisher
Oct 8, 2017·Archives of Orthopaedic and Trauma Surgery·Alberto Izquierdo-FernándezPedro Carpintero-Benítez
Mar 12, 2019·The New England Journal of Medicine·Jeffrey H SilberUNKNOWN iCOMPARE Research Group
Jan 1, 2012·Journal of the American Statistical Association·José R ZubizarretaPaul R Rosenbaum
Oct 7, 2020·Journal of Orthopaedic Surgery·Ong-Art PhruetthiphatJohn J Callaghan
Mar 30, 2020·BMJ Quality & Safety·Karen B LasaterJeffrey H Silber
Jun 13, 2019·Annals of Surgery·Rachel R KelzJeffrey H Silber
May 9, 2014·The Journal of Bone and Joint Surgery. American Volume·Hilal Maradit KremersDavid G Lewallen
Jul 18, 2014·The Journal of Bone and Joint Surgery. American Volume·Ioannis PappouMark A Frankle
Feb 11, 2021·Diabetes, Metabolic Syndrome and Obesity : Targets and Therapy·Merridie ReesVanessa M McDonald

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