Morbidly obese patients were also associated with $20,000 more per admission in charges, according to Paul A. Kalanithi, MD.
The investigators used the Healthcare Cost and Utilization Project’s California State Inpatient Databases to perform a retrospective cross-sectional study of all spine fusions from 2003 to 2007. They identified normal weight and morbidly obese patients admitted within that time span for four types of spine fusion: anterior cervical fusion, posterior cervical fusion, anterior lumbar fusion and posterior lumbar fusion. The authors collected data on demographics, comorbidities and complications, using a primary outcome of in-hospital complications and secondary outcomes of total cost, length of stay and in-hospital mortality.
According to the study results, the authors identified 84,607 admissions. Of these, 1,455 (2%) were for morbidly obese patients. The authors found in-hospital complication rates of 13.6% for morbidly obese patients vs. 6.9% for noral weight patients. Morbidly obese patients also showed higher mortality, about $24,000 more in average hospital costs and 1.3 days longer average length of stay.
All effects, the authors noted, were less pronounced in posterior cervical fusions. Morbid obesity was the most significant predictor of complications in anterior cervical and posterior lumbar fusion patient subsets.
According to a release, the authors noted that while surgeons and patients should be aware of the excess risks, the findings do not mean that spinal fusion should not be performed in patients with severe obesity, when indicated.
Indeed, in-hospital mortality in morbidly obese patients in this study was less than 1%, and in-hospital complication rates … were under 15%,” the authors wrote.
Kalanithi PA, Arrigo R, Boakye M. Morbid obesity increases cost and complication rates in spinal arthrodesis. Spine. 2012. doi: 10.1097/BRS.0b013e31823bbeef