The impact of bariatric surgery on comorbidities and medication use among obese patients.
BACKGROUND
The risks and benefits of bariatric surgery have rarely been evaluated in large multiyear patient samples. This study identifies the short- and long-term impact of bariatric surgery on comorbidities and medication use among obese patients.


METHODS
A comprehensive analysis of 5,502 obese patients who underwent bariatric surgery was performed. Submissions of reimbursement claims, including diagnostics and medication use, were compared in the 90 days preceding the surgery and 30 up to 1,110 days following the surgery. Presurgery and postsurgery frequency counts were performed on diagnostics and medication use to identify trends.


RESULTS
Among 5,502 patients, significant decreases in the prevalence of reported comorbidities were observed during the short-term postsurgery period and sustained for up to 3 years of follow-up. Compared to the presurgery period, significant decreases (p < 0.05) were observed after 3 years for total cardiovascular disorders (43.6% vs. 14.2%), diabetes mellitus (19.9% vs. 7.7%), chronic obstructive pulmonary disease and other respiratory conditions (57.7% vs. 16.2%), diseases of the musculoskeletal system and connective tissue (32.6% vs. 27.7%), and mental disorders (30.7% vs. 14.8%). Over the same period, the frequency of medication use decreased significantly for a number of conditions including infections, pain, respiratory, cardiovascular, gastroenterologic, lipidemic, and diabetic conditions. Anemia, however, increased from 3.8% to 9.9%, and use of nutritional supplements increased significantly.


CONCLUSIONS
Bariatric surgery was associated with significant reductions in reported claims for short- and long-term health outcomes and reduced medication use for major disease categories.
Crémieux
Pierre-Yves
PY
Hôpital Hotel-Dieu (AP-HP), Paris, France. pcremieux@analysisgroup.com
Ledoux
Severine
S
Clerici
Christine
C
Cremieux
Francois
F
Buessing
Marric
M
D000328:Adult; D050110:Bariatric Surgery; D015897:Comorbidity; D011307:Drug Prescriptions / Q000191:economics*; D004358:Drug Therapy / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007349:Insurance, Health, Reimbursement; D008297:Male; D009767:Obesity, Morbid / Q000191:economics / Q000453:epidemiology / Q000601:surgery*; D011182:Postoperative Care / Q000191:economics* / Q000379:methods; D011306:Prescription Fees / Q000706:statistics & numerical data; D015995:Prevalence; D011788:Quality of Life; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology; D015431:Weight Loss