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Study finds obesity increases time in OR for lung surgery

Dec. 13, 2012, 10:02 AM

A new study led by Vanderbilt University Medical Center investigators found that obese patients undergoing surgery for lung cancer spent more time in the operating room, adding to the nation’s health care bill.

The researchers found that for every extra 10 kg/m² body mass index (BMI), the time spent in the operating room increased by 7.2 minutes. Extra time can be spent moving and positioning the patient, which often requires additional staff, preparing special operating tables and using specialized tools.

Eric Grogan, M.D., MPH

According to the study, which was published in the December issue of the Annals of Thoracic Surgery, obese patients spent more time in the operating room, even at institutions with experience dealing with obese patients.

Previously published data indicates patients are charged approximately $62 per minute of operating room time, so the authors estimate that every 10-unit increase in BMI costs an additional $446.

“Operating room costs are substantial, so obesity is certainly adding to our overall health care expenditures,” said senior author Eric Grogan, M.D., MPH, assistant professor of Thoracic Surgery and Medicine, Institute for Medicine and Public Health.

The investigators studied the records for 19,337 patients in the Society of Thoracic Surgeons General Thoracic Surgery database who underwent a lobectomy for lung cancer between 2006 and 2010 — 4,898 of the patients had a BMI of 30 kg/m² or greater and were considered obese and 625 were considered morbidly obese.

Obese patients were more likely to be young, black and former smokers with more complicated health care issues than the non-obese patients.

While it took longer to care for those obese patients in the OR, adding to the overall health care bill, obese patients did not spend more time in the hospital and were not more likely to die within 30 days.

Jamii St. Julien, M.D., MPH

The authors concluded that if obesity continues to rise among the U.S. population, a larger number of patients undergoing lung cancer surgery will be obese, contributing to an increase in operating room costs.

“We are putting more and more resources into caring for obese patients and hospitals and policymakers need to consider these costs as they deal with rising obesity levels,” said first author Jamii St. Julien, M.D., MPH.

Other Vanderbilt investigators who participated in the study include Melinda Aldrich, Ph.D., MPH, Stephen Deppen, M.A., M.S., Joe B. (Bill) Putnam, M.D., Eric Lambright, M.D., Jonathan Nesbitt, M.D., and Shubin Sheng, M.S., Duke Clinical Research Institute, Durham, N.C., and William Burfeind Jr., M.D., St. Luke’s Health Network, Bethlehem, Pa.

Funding support was provided to Grogan by the Department of Veterans Affairs (CDA – 10-024) and St. Julien is a recipient of a Vanderbilt University Surgical Oncology T32 Training Grant.

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