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Hospital Labels Do Not Guarantee Better Weight-Loss Surgery

Posted on: Tuesday, 21 April 2009, 07:57 CDT

According to U.S. researchers, hospital-appointed bariatric surgery “centers of excellence” suffer as many complications and fatalities from weight-loss procedures as other medical facilities engaging in these operations, Reuters accounted on Monday. 

The researchers suppose the extra expense and exertion called for by hospitals to receive such a sought-after title might not be worth it.

Dr. Edward Livingston of the University of Texas Southwestern School of Medicine, said in a statement, “Designation as a bariatric surgery center of excellence does not ensure better outcomes.”  His study is published in the Archives of Surgery. 

Treating obesity with bariatric surgery is rapidly becoming more popular.  The goal of the surgery is to rework the digestive tract for the purpose of reducing the volume of food that can be consumed and digested.

An additional study in the same journal examined the advantages of the surgery in patients suffering from severe obesity. 

Severely obese individuals may benefit from insurance assistance, even if partial, which ranges in cost from $15,000 to $35,000.  Many of these contributing insurance companies, including Medicare -- the federal health plan for 44 million elderly and disabled Americans -- authorize the procedures to be conducted strictly at hospitals designated as a bariatric center of excellence. 

Livingston investigated to find out if patients at these centers received better care in actuality.  His research included intense scrutiny of data on 19,363 patients who had bariatric surgery in 2005.  Of these, 5,420 patients received surgery at centers of excellence. 

Results indicated that 1.7 percent of bariatric surgery patients who underwent treatment at a center of excellence died and 6.3 percent suffered complications.  In comparison with a death rate of .09 percent and a complication rate of 6.4 percent at hospitals lacking the prominent title.

In order to substantiate the “center of excellence” title, a hospital must hire extra staff, making it more expensive to operate.  However, “extra expenses associated with center of excellence designation may not be warranted,” Livingston suggested.

Another study in the same journal reviewed the effects of gastric bypass surgery in two groups of severely obese patients: the morbidly obese, indicated by those with a body mass index of 40 to 49, and the super obese, indicated by those with a body mass index of 50 or higher. 

A formula used to calculate obesity, body mass index (BMI), takes into account an individual’s height and weight.  A person is considered obese if their BMI is 30 or above. BMI of 25 to 30 is considered overweight. 

At the Hospital du Chablais in Lausanne, Switzerland, Dr. Michael Suter and his colleagues looked at 492 morbidly obese patients and 133 super obese patients treated with gastric bypass between years 1999 and 2006.

The team found that while the super obese patients lost more weight (37.3 percent of their body weight) than the morbidly obese patients (34.7 percent of their body weight), less than half of the super obese lost enough to be considered overweight six years after the surgery, compared with more than 90 percent of the morbidly obese patients.   

In spite of these differences, improvements in quality of life and other health measures were mostly the same in both groups.  Earlier research found that obese people who undergo weight-loss surgery are less inclined to die from heart disease, diabetes and cancer than obese people who do not. 

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On the Net:

• University of Texas Southwestern School of Medicine
• Archives of Surgery

Source: redOrbit Staff & Wire Reports

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