The relation of body weight to length of stay and charges for hospital services for patients undergoing elective surgery: a study of two procedures.

A, Epstein; Read, John; Hoefer, Martha A.

doi:10.2105/ajph.77.8.993

Cited by 74 publications

(41 citation statements)

References 25 publications

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“…For example, a large-scale study [15] included 35,000 orthopaedic surgeries and the length of stay was 1.1 days longer for morbidly obese patients, but it has been difficult to show this association in previous THA studies [4,10,14,19,21,33]. We believe this is a result of methodologic issues, including small sample sizes, power, measurement of obesity, and cost outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…Despite the increasing prevalence of obesity among patients undergoing THA, there are few studies examining the potential financial implications of obesity in this patient population [4,10,14,19,21,33]. We therefore examined the association between BMI and length of stay and costs taking into account obesity-related comorbidities and short-term THA complications.…”

Section: Discussionmentioning

confidence: 99%

“…Some previous studies examined the impact of obesity on healthcare use and costs in THA with discrepant findings [4,10,14,19,21,33,39], attributable in part to methodologic differences in terms of sample size and power, definition of obesity, ascertainment and costing of use data, and adjustment for potential confounders such as comorbidities. Obesity is a risk factor for several costly comorbidities.…”

Section: Introductionmentioning

confidence: 99%

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Obesity Increases Length of Stay and Direct Medical Costs in Total Hip Arthroplasty

Kremers

Visscher

Kremers

et al. 2014

Clinical Orthopaedics &Amp; Related Research

119

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Background The number of obese patients undergoing THA is increasing. Previous studies have shown that obesity is associated with an increased likelihood of complications after THA, but there is little information regarding the impact of obesity on medical resource use and direct medical costs in THA. Questions/purposes We sought to examine the relationship between obesity, length of stay, and direct medical costs in a large cohort of patients undergoing THAs. Methods The study included 8973 patients who had undergone 6410 primary and 2563 revision THAs at a large US medical center between January 1, 2000, and September 31, 2008. Patients with bilateral procedures within 90 days after index admission and patients with acute trauma were excluded. Data regarding clinical, surgical characteristics, and complications were obtained from the original medical records and the institutional joint registry. Patients were classified into eight groups based on their BMI at the time of surgery. Direct medical costs were calculated by using standardized, inflation-adjusted costs for services and procedures billed during hospitalization and the 90-day window. Study end points were hospital length of stay, direct medical costs during hospitalization, and the 90-day window. End points were compared across the eight BMI categories in multivariable risk-adjusted linear regression models. Results Mean length of stay and the direct medical costs were lowest for patients with a BMI of 25 to 35 kg/m 2 . Increasing BMI was associated with longer hospital stays and costs. Every five-unit increase in BMI beyond 30 kg/ m 2 was associated with approximately USD $500 higher hospital costs and USD $900 higher 90-day costs in primary THA (p = 0.0001), which corresponded to 5% higher costs. The cost increase associated with BMI was

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Obesity Increases Length of Stay and Direct Medical Costs in Total Hip Arthroplasty

Kremers

Visscher

Kremers

et al. 2014

Clinical Orthopaedics &Amp; Related Research

119

View full text Add to dashboard Cite

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“…Increased LOS has been previously documented in obese patients undergoing TKA and THA [13]. Schwarzkopf et al demonstrated a LOS increase by 13.8% for each 5-unit increase in BMI above 45.…”

Section: Discussionmentioning

confidence: 89%

“…The majority of the current literature would indicate higher perioperative complication rates following TJA in the obese population including longer operative times, increased wound complications/infections, and increased hospital length of stay (LOS) and cost [11][12][13][14]. However, obesity risk assessment is a complicated condition that is compounded by other associated major comorbidities (diabetes mellitus, hypertension, coronary artery disease) that independently increase surgical risk [15].…”

mentioning

confidence: 99%