title: Comorbidity among the morbidly obese: a comparative study of 2002 U.S. hospital patient discharges.
abstract: BACKGROUND
  Increased morbidity is associated with increasing severity of obesity. However, among morbidly obese patients, comorbid prevalence has been reported primarily in the bariatric surgical literature. This study compares demographic characteristics and selected comorbid conditions of morbidly obese patients discharged after surgical obesity procedures and morbidly obese patients discharged after all other hospital procedures.
  
  
  METHODS
  The 2002 National Hospital Discharge Survey (a nationally representative sample of hospital discharge records) and the International Classification of Diseases, 9th Revision, Clinical Modification were used to identify and describe all morbidly obese patient discharges (n = 3,473) and to quantify the prevalence of selected obesity-related comorbid conditions.
  
  
  RESULTS
  Compared with all other morbidly obese patients, the obesity surgery patients (n = 833) were younger (median, 42 vs 48 years; range, 17 to 67) and more female (82.3% vs. 63.7%), with higher rates of sleep apnea (24.0% vs. 11.8%), osteoarthritis (22.9% vs. 11.8%), and gastroesophageal reflux disease (27.7% vs. 11.7%) (all P < .001). The prevalence of type 2 diabetes mellitus was lower in the obesity surgery patients (16.1% vs. 24.3%; P = .003), whereas the rates of hypertension (45.9% vs. 41.0%; P = .13) and asthma (9.6% vs. 12.0%; P = .26) were similar in the two groups.
  
  
  CONCLUSIONS
  Demographic characteristics and comorbid prevalence of morbidly obese patients discharged after obesity surgery are consistent with reports in the bariatric surgical literature. Obesity surgery patients had a higher prevalence of some comorbid conditions. Possible explanations for this include preferential diagnosis, differential diagnostic coding, or increased severity of morbid obesity. Advancing surgical and insurance guidelines for bariatric surgery will require clinical data that accurately describe and quantify the demographic distribution of obesity and the associated burden of disease.
authors.affiliation: Division of Epidemiology, School of Public Health, The Ohio State University, Columbus, Ohio 43210, USA. scott.788@osu.edu
authors.forename: Susanne K
authors.initials: SK
authors.lastname: Scott
authors.forename: Felicia A
authors.initials: FA
authors.lastname: Rabito
authors.forename: Phillip D
authors.initials: PD
authors.lastname: Price
authors.forename: Nancy N
authors.initials: NN
authors.lastname: Butler
authors.forename: Judith A
authors.initials: JA
authors.lastname: Schwartzbaum
authors.forename: Benita M
authors.initials: BM
authors.lastname: Jackson
authors.forename: Randi L
authors.initials: RL
authors.lastname: Love
authors.forename: Randall E
authors.initials: RE
authors.lastname: Harris
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000453:epidemiology / Q000601:surgery; D010351:Patient Discharge; D015995:Prevalence; D014481:United States / Q000453:epidemiology