BEFORE-AND-AFTER STUDY: DOES BARIATRIC SURGERY REDUCE HEALTHCARE UTILIZATION AND RELATED COSTS AMONG OPERATED PATIENTS?

2015 ◽  
Vol 31 (6) ◽  
pp. 407-413 ◽  
Author(s):  
Silvana Marcia Bruschi Kelles ◽  
Carla Jorge Machado ◽  
Sandhi Maria Barreto
Keyword(s):  
Bariatric Surgery ◽  
Hospital Admissions ◽  
Healthcare Providers ◽  
Gastrointestinal Diseases ◽  
Emergency Department Visits ◽  
Morbidly Obese ◽  
Insurance Company ◽  
Healthcare Use ◽  
Esthetic Surgery ◽  
Before And After

Background: Healthcare use and costs are about 81% higher for morbidly obese individuals compared to non-obese persons, and 47% higher compared to the non-morbidly obese population. The benefits of bariatric surgery for health are well established, but its mid-term impact on healthcare use and costs remains controversial.Methods: This study examines the trends in healthcare use and costs in a Brazilian cohort during a 4-year period before and after surgery. Healthcare use and direct costs related to inpatients and outpatients were retrieved from a healthcare insurance company database from which all cohort members were selected.Results: Between 2004 and 2010, 4,006 individuals underwent bariatric surgery. Most patients were female (80%) with a mean age of 36.2 years and a mean body mass index of 42.8 kg/m2. Elevated blood pressure was present in 38% of cases and diabetes was found in 12.5% of subjects. Hospital admissions increased consistently after surgery, even after excluding hospitalizations for esthetic surgery and pregnancy-related care. The most prevalent conditions in this group were gastrointestinal diseases. Emergency department visits increased after bariatric procedures, in particular for genitourinary and hematologic problems. Adjusted costs were higher after surgery as assessed during a 4-year follow-up period.Conclusion: Results indicate that costs and hospital admissions after bariatric surgery increase following this procedure, even when elective interventions are excluded. Healthcare providers and policy makers need to be aware that a decrease in obesity-related diseases following bariatric surgery does not reduce healthcare use and costs.

scholarly journals Provision of nutritional support to those experiencing complications following bariatric surgery

2010 ◽  
Vol 69 (4) ◽  
pp. 536-542 ◽  
Author(s):  
Ella Segaran
Keyword(s):  
Bariatric Surgery ◽  
Energy Expenditure ◽  
Hospital Admissions ◽  
Nutrition Support ◽  
Considerable Proportion ◽  
Obese Patients ◽  
Free Living ◽  
Protein Requirements ◽  
Before And After ◽  
Oral Diet

This review details the practicalities of providing nutrition support to obese patients who experience complications following bariatric surgery and highlights some of the nutritional challenges encountered by this group of patients. Bariatric surgery to treat morbid obesity has significantly increased internationally over the past decade with hospital admissions rising annually. The gastric bypass is currently the most commonly performed procedure. The complication rate can be up to 16%, with a considerable proportion having nutritional implications. The treatment can involve avoidance of oral diet and nutrition support, i.e. enteral or parenteral nutrition. Opposition to nutrition support can be encountered. It is useful to clarify the aims of nutrition support, these being: the avoidance of overfeeding and its consequences, preservation of lean body mass and promotion of healing. Evidence suggests that hypoenergic nutrition is not harmful and may actually be beneficial. There is a lack of consensus regarding the optimum method to predict the nutritional requirements in the obese acutely unwell patient. The literature suggests that the predicted equations are fairly accurate compared to measured energy expenditure in free living obese patients before and after bariatric surgery. However, these findings cannot be directly applied to those obese patients experiencing complications of bariatric surgery, who will be acutely unwell exhibiting inflammatory response. It is therefore necessary to refer to the literature on energy expenditure in hospitalized obese patients, to help guide practice. More research examining the energy and protein requirements of obese patients needing nutrition support following bariatric surgery is urgently required.

Anti-Xa Levels in Morbidly Obese Patients Using Apixaban or Rivaroxaban, Before and After Bariatric Surgery

2021 ◽  
Author(s):  
Thom Kok ◽  
Hans de Boer ◽  
Bart Witteman ◽  
Marcel Hovens ◽  
Matthijs van Luin ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Morbidly Obese ◽  
Obese Patients ◽  
Before And After

Ventilation/Perfusion Distribution Abnormalities In Morbidly Obese Subjects Before and After Bariatric Surgery

CHEST Journal ◽  
2015 ◽  
Vol 147 (4) ◽  
pp. 1127-1134 ◽  
Author(s):  
Eva Rivas ◽  
Ebymar Arismendi ◽  
Alvar Agustí ◽  
Marcelo Sanchez ◽  
Salvadora Delgado ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Morbidly Obese ◽  
Before And After ◽  
Obese Subjects

scholarly journals Medication and nutritional supplement use before and after bariatric surgery

2016 ◽  
Vol 134 (6) ◽  
pp. 491-500 ◽  
Author(s):  
Charline Fernanda Backes ◽  
Edyane Lopes ◽  
Airton Tetelbom ◽  
Isabela Heineck
Keyword(s):  
Bariatric Surgery ◽  
Drug Use ◽  
Antihypertensive Drugs ◽  
Nutritional Supplement ◽  
Morbidly Obese ◽  
Preoperative Period ◽  
Porto Alegre ◽  
Supplement Use ◽  
Before And After ◽  
The Impact

ABSTRACT CONTEXT AND OBJECTIVE: Bariatric surgery has been an effective alternative treatment for morbid obesity and has resulted in decreased mortality, better control over comorbidities and reduced use of drugs. The objective of this study was to analyze the impact of bariatric surgery on medication drug and nutritional supplement use. DESIGN AND SETTING: Longitudinal study of before-and-after type, on 69 morbidly obese patients in a public hospital in Porto Alegre. METHODS: Through interviews, the presence of comorbidities and use of drugs with and without prescription were evaluated. RESULTS: Among the 69 patients interviewed, 85.5% had comorbidities in the preoperative period, with an average of 2.3 (± 1.5) per patient. The main comorbidities reported were hypertension, diabetes and dyslipidemia. 84.1% of the patients were using prescribed drugs in the preoperative period. The mean drug use per patient was 4.8, which decreased to 4.4 after the procedure. The surgery enabled significant reduction in use of most antidiabetic (84%), antilipemic (77%) and antihypertensive drugs (49.5%). On the other hand, there was a significant increase in use of multivitamins and drugs for disorders of the gastrointestinal tract. The dosages of most of the drugs that continued to be prescribed after surgery were decreased, but not significantly. CONCLUSION: After bariatric surgery, there were increases in the use of vitamins, gastric antisecretory drugs and antianemic drugs. Nevertheless, there was an overall reduction in drug use during this period, caused by suspension of drugs or dose reduction.

scholarly journals VOCAL COMPLAINT, AUDITORY-PERCEPTUAL ASSESSMENT OF VOICE AND VOCAL SELF-ASSESSMENT IN WOMEN WITH MORBID OBESITY

2015 ◽  
Vol 28 (suppl 1) ◽  
pp. 23-25 ◽  
Author(s):  
Lourdes Bernadete Rocha de SOUZA ◽  
Leandro de Araujo PERNAMBUCO ◽  
Marquiony Marques dos SANTOS ◽  
Joana Cristina Vasconcelos da SILVA
Keyword(s):  
Bariatric Surgery ◽  
Morbid Obesity ◽  
Morbidly Obese ◽  
Self Assessment ◽  
Obese People ◽  
Voice Production ◽  
Perceptual Evaluation ◽  
Before And After ◽  
Perceptual Assessment ◽  
The Voice

Background : Obese people often have altered breathing patterns and therefore may experience difficulties in voice production. Aim : To verify the presence of vocal complaints and the correlation between the auditory-perceptual analysis of voice and vocal self-assessment of a group of women with morbid obesity before and after bariatric surgery. Methods : A longitudinal, exploratory, descriptive study of 21 morbidly obese women aged between 28 and 68 years, assessed before and after bariatric surgery, was performed. The women filled out a form containing identification data and type of vocal complaint. Perceptual evaluation of voice and vocal self-assessment were performed using a visual analog scale. For perceptual assessment of voice the women were asked to say three sentences from the Consensus Auditory-Perceptual Evaluation of Voice. Results : Of the 21 patients, 14 (66.6%) reported vocal complaints, of which 10 (71%) vocal fatigue, eight (57.14%) voice failures and seven (50%) vocal effort. All participants reported improvements in the voice after surgery, irrespective of having reported vocal complaints before surgery. There was no correlation between vocal self-assessment and auditory-perceptual assessment of the voice before or after the procedure. There was no correlation between vocal self-assessment and perceptual evaluation of the voice before surgery. Conclusion : Obesity interfered with voice production and influenced negative perception and therefore vocal complaints. Complaints about vocal production cannot be perceived by a speech therapist with the same impact as by patients, as both employ different criteria for vocal evaluation. Vocal self-assessment is an important tool in voice evaluation.

scholarly journals Quantification of epicardial adipose tissue in morbidly obese patients before and after bariatric surgery

2014 ◽  
Vol 16 (S1) ◽  
Author(s):  
María Luaces ◽  
Victoria Cachofeiro ◽  
Jorge Cabezudo Pedrazo ◽  
Alfonso Antequera-Pérez ◽  
Manuel Medina-García ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Adipose Tissue ◽  
Epicardial Adipose Tissue ◽  
Morbidly Obese ◽  
Obese Patients ◽  
Before And After
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