Obesity ramps up thoracic surgery costs

By Sarah Guy, medwireNews Reporter

Obese patients have significantly increased operating times when undergoing lobectomy for primary lung cancer, show US study results.

Every 10-unit increase in body mass index (BMI) is associated with a significant 7.2-minute increase in mean total operating room (OR) time, which could represent a major source of high healthcare costs associated with obesity in the USA, say the researchers.

The finding "must be considered on both a hospital and a national policy level," write Eric Grogan (Vanderbilt University, Nashville, Tennessee) and colleagues in the Annals of Thoracic Surgery.

The study cohort included 19,337 individuals treated with lobectomy between 2006 and 2010, whose data is stored in the Society of Thoracic Surgeons General Thoracic Surgery database.

Patients had a mean BMI of 27.3 kg/m², where a BMI of 30.0 kg/m² indicated obesity, and the majority of the cohort (68.4%) had a BMI under this level.

The mean total OR time was 240 minutes, and the mean length of stay in hospital was 6.9 days. A total of 1.8% of all patients died within 30 days of their surgery.

OR times rose incrementally with increasing BMI above the obesity threshold, report the researchers, such that a lobectomy in a patient with a BMI of 45 kg/m² took approximately 15 minutes longer than one in a patient with a BMI of 25 kg/m² .

In addition, black race, male gender, and preoperative chest radiation therapy were also significantly associated with longer OR time, increasing the procedure length by a respective 7.2, 19.2, and 16.8 minutes.

The reasons for these associations are unclear, write the authors, but imply "that there are other factors associated with race and sex that still need to be elucidated."

Grogan and co-workers found no significant association between obesity and 30-day mortality, contrary to previous research.

"If the prevalence of obesity continues to rise, a greater number of patients undergoing lobotomies for lung cancer will likely be obese," they conclude.

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