Population-based study of trends, costs, and complications of weight loss surgeries from 1990 to 2002.
OBJECTIVE
To describe the trends, costs, and complications associated with weight loss surgery (WLS).


METHODS
Wisconsin inpatient hospital discharge data from 1990 to 2003 were used for analysis. A WLS case was defined as anyone with a WLS-related procedure code and a primary diagnosis of morbid obesity. Charges were inflation-adjusted to 2001 constant dollars; complications were defined on the basis of readmission, extended length of stay, repeat surgical procedures, or death.


RESULTS
The number of WLSs increased from 269 in 1990 to 1992 to 1,884 in 2000 to 2002 (rate ratio = 4.6). Increases in WLSs were greatest among those 50 to 59 years of age (rate ratio = 6.4), women (rate ratio = 6.8), and blacks (rate ratio = 20.0). Between the two periods, inflation-adjusted WLS charges increased 12-fold, and the inflation-adjusted charge per procedure doubled, despite a decreased length of stay. For 2000 to 2002, 23.3% of WLS patients had either an extended length of stay or readmission within 30 days, 7.4% required a repeat surgical procedure, and 0.7% died.


CONCLUSIONS
In Wisconsin, the rate and costs of WLSs have increased dramatically, and the incidence of postoperative complications was high. The epidemic of obesity in the United States makes it imperative to better assess the cost-effectiveness of WLS and to improve its safety.
Mehrotra
Chetna
C
Division of Nutrition and Physical Activity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA. bfz1@cdc.gov
Serdula
Mary
M
Naimi
Timothy S
TS
Khan
Laura Kettel
LK
Miller
Jacqueline
J
Dietz
William
W
D000293:Adolescent; D000328:Adult; D050110:Bariatric Surgery / Q000009:adverse effects / Q000191:economics / Q000706:statistics & numerical data / Q000639:trends; D018672:Community Health Planning / Q000706:statistics & numerical data*; D003362:Cost-Benefit Analysis; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects / Q000191:economics / Q000639:trends; D015390:Gastric Bypass / Q000009:adverse effects / Q000191:economics / Q000639:trends; D006801:Humans; D015994:Incidence; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications / Q000453:epidemiology / Q000401:mortality / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology; D012086:Reoperation; D017792:Surgical Stapling / Q000009:adverse effects / Q000191:economics / Q000639:trends; D014922:Wisconsin / Q000453:epidemiology