Surgical Complications 12 Times More Likely in Obese Patients
Wednesday, 6 July 2011
Obese patients are nearly 12 times more likely to suffer a complication following elective plastic surgery than their normal-weight counterparts, according to new research by Johns Hopkins scientists.
“Our data demonstrate that obesity is a major risk factor for complications following certain kinds of elective surgery,” says Marty Makary, MD, MPH, an associate professor of surgery at the Johns Hopkins University School of Medicine and leader of the study published online in the journal Plastic and Reconstructive Surgery.
Not only are these findings relevant to physicians who need to pay special heed to issues such as potential surgical-site infections in heavier patients but, the authors argue, they are relevant to policymakers whose increasingly applied metrics for surgical quality and reimbursement do not account for the higher risk of worse outcomes in the obese.
“With the government and other insurers penalizing doctors whose patients get infections or are readmitted to the hospital—and with obese patients more likely to have those problems—policymakers need to make sure they aren’t giving physicians financial incentives to discriminate on the basis of weight,” Makary says.
Thirty-four percent of adults in the United States are now estimated to be obese (those with a body mass index above 30), up from just 15% a decade ago. Meanwhile, the number of people nationwide having elective plastic surgery has also increased in recent years, with annual plastic surgery volume up 725% between 1992 and 2005.
Surgical outcomes are increasingly judged using standardized measures to evaluate quality and to inform the public and insurance companies. These metrics also are used more and more to penalize hospitals with higher complication rates. But, Makary says, they do not take into account that obese patients may suffer more complications, as this new research finds.
Operations on obese patients are more taxing, says Makary, a surgeon himself. These surgeries take usually take longer, the operating fields are deeper, the spaces in which an infection can set in are often greater, and blood flow in fat tissue is less than in other types of tissue, which results in slower healing, he says.
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Source: Johns Hopkins University School of Medicine
Posted byLaurence Kirwan at 18:06
