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Granel Villach L, Laguna Sastre JM, Ibáñez Belenguer JM, Beltrán Herrera HA, Queralt Martín R, Fortea Sanchis C, Martínez Ramos D, Escrig Sos VJ. Analysis of the impact of bariatric surgery on medium-term pharmacological expenditure. Cir Esp 2021; 99:737-744. [PMID: 34776409 DOI: 10.1016/j.cireng.2021.10.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Accepted: 11/06/2020] [Indexed: 10/19/2022]
Abstract
INTRODUCTION Obesity and associated diseases represent an important health and economic problem since pharmacological treatment for many of these pathologies needs lifelong subsidies. Theoretically, bariatric and metabolic surgery decreases the medication requirements of patients for these diseases but may result in other types of pharmacological needs. This study aims to demonstrate whether there is a real decrease in pharmacological expenditure after bariatric surgery. MATERIAL AND METHODS Retrospective cross-sectional analysis of patients who were treated in our centre between 2012 and 2016, comparing different associated comorbidities and pharmacological expenses one month before and 2 years after surgery. RESULTS 400 patients were operated. The results were presented, showing the differences between the resolution of the different comorbidities and the pharmacological savings generated for each of the surgical techniques studied. The most cost-effective comorbidity in the study was type 2 diabetes mellitus (DM2). The surgical technique with the best results was metabolic bypass, presenting a cost difference after surgery of 507 euros per month (P < 0.001). CONCLUSIONS In a 2-year follow-up after bariatric surgery, a decreased prevalence of obesity-related diseases and associated pharmacological expenditure was observed, showing the efficiency of this intervention over the medium term.
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Affiliation(s)
- Laura Granel Villach
- Cirugía General y del Aparato Digestivo, Hospital General Universitario de Castellón, Castellón, Spain.
| | - José Manuel Laguna Sastre
- Cirugía General y del Aparato Digestivo, Hospital General Universitario de Castellón, Castellón, Spain; Universitat Jaume I, Castellón, Spain
| | | | | | - Raquel Queralt Martín
- Cirugía General y del Aparato Digestivo, Hospital General Universitario de Castellón, Castellón, Spain
| | - Carlos Fortea Sanchis
- Cirugía General y del Aparato Digestivo, Hospital General Universitario de Castellón, Castellón, Spain
| | - David Martínez Ramos
- Cirugía General y del Aparato Digestivo, Hospital General Universitario de Castellón, Castellón, Spain
| | - Vicente Javier Escrig Sos
- Cirugía General y del Aparato Digestivo, Hospital General Universitario de Castellón, Castellón, Spain; Universitat Jaume I, Castellón, Spain
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Ruiz de Angulo D, Balaguer Román A, Munitiz Ruiz V, Gil Vázquez PJ, Ruiz Merino G, Ortiz Escandell MÁ, Martínez de Haro LF, Parrilla Paricio P. Influence of the lockdown due to COVID-19 on weight-loss results during the first year after sleeve gastrectomy. Cir Esp 2021; 99:428-432. [PMID: 34130814 PMCID: PMC8114763 DOI: 10.1016/j.cireng.2021.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Accepted: 08/04/2020] [Indexed: 12/03/2022]
Abstract
Introduction COVID-19 pandemic has lead to lockdown of population in many countries. In Spain, the state of alarm was established from March 15 to June 20, 2020. Usually this fact decreased people's mobility and physical activity, in addition to producing or exacerbating psychological disorders. Our aim was to determine the influence that this condition had over the short-term ponderal results of patients undergoing laparoscopic vertical gastrectomy from May 2019 to May 2020. Methods Case–control study for comparing the percentage of excess weight lost (%EWL) and the percentage of total weight lost (%TWL) of patients that underwent a VG during the last year, so they were affected by lockdown in April and part of March 2020 (group 1), to the %EWL and %TWL of a control group (group 2), obtained from our previous series. Results The mean %EWL in group 1 is 47.37 ± 18.59 and in group 2 is 51.13 ± 17.59, being P=.438. Meanwhile, the mean %TWL in group 1 is 21.14 ± 8.17 and in group 2 is 24.67 ± 8.01, with P=.115. Conclusions Population lockdown by COVID-19 did not get worse short-term results of vertical gastrectomy. More studies with a larger number of patients are necessary to draw firm conclusions.
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Affiliation(s)
- David Ruiz de Angulo
- Unidad de Cirugía Esofagogástrica y Obesidad, Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario Virgen de la Arrixaca, Murcia, Spain.
| | - Andrés Balaguer Román
- Servicio de Cirugía General y Aparato Digestivo, Hospìtal Universitario Virgen de la Arrixaca, Murcia, Spain
| | - Vicente Munitiz Ruiz
- Unidad de Cirugía Esofagogástrica y Obesidad, Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario Virgen de la Arrixaca, Murcia, Spain
| | - Pedro José Gil Vázquez
- Servicio de Cirugía General y Aparato Digestivo, Hospìtal Universitario Virgen de la Arrixaca, Murcia, Spain
| | - Guadalupe Ruiz Merino
- Unidad de Bioestadística, Instituto Murciano de Investigación Biosanitaria (IMIB), Spain
| | - M Ángeles Ortiz Escandell
- Unidad de Cirugía Esofagogástrica y Obesidad, Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario Virgen de la Arrixaca, Murcia, Spain
| | - Luisa F Martínez de Haro
- Unidad de Cirugía Esofagogástrica y Obesidad, Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario Virgen de la Arrixaca, Murcia, Spain
| | - Pascual Parrilla Paricio
- Unidad de Cirugía Esofagogástrica y Obesidad, Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario Virgen de la Arrixaca, Murcia, Spain
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Kraus-Fischer G, Alfonso-Ballester R, Mora-Oliver I, Cassinello-Fernández N, Ortega-Serrano J. Effectiveness and efficiency of a special program to reduce the bariatric surgery waiting list at a tertiary hospital. Cir Esp 2021; 99:276-281. [PMID: 32674840 PMCID: PMC7358759 DOI: 10.1016/j.ciresp.2020.05.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 05/15/2020] [Accepted: 05/30/2020] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Bariatric surgery is one of the most common surgical practices in Spain. However, this procedure currently has longest delay on surgical waiting lists (SWL). We have developed a special surgical program that aims to reduce this waiting list and to assess the economic and clinical repercussions in a high-volume bariatric surgery unit. METHODS A three-month prospective study was carried out comparing outcomes, results and perioperative resources consumed for 45 patients who underwent bariatric surgery. The patients were divided into 2 groups: patients who underwent the standard procedure in the operating room, and patients treated in the special program. Epidemiological, healthcare and economic factors were taken into account. RESULTS Two homogeneous groups of patients were operated on, successfully reducing the SWL. Morbidity was similar in both groups and the average cost of the surgeries performed was €5,331.40; in the standard group, the cost was €5,372.50±€798.10, and the cost of the special program group was €5,290.30±€685.10, with no significant differences. CONCLUSIONS In hospitals with a high volume of bariatric surgery, it is feasible to incorporate special surgical programs that are able to reduce surgical waiting lists, while maintaining quality criteria and without incurring a greater expense to the healthcare system.
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Affiliation(s)
- Gabriel Kraus-Fischer
- Unidad de Cirugía Endocrina y Bariátrica, Servicio de Cirugía General y del Aparato Digestivo, Hospital Clínico Universitario de Valencia, Valencia, España
| | - Raquel Alfonso-Ballester
- Unidad de Cirugía Endocrina y Bariátrica, Servicio de Cirugía General y del Aparato Digestivo, Hospital Clínico Universitario de Valencia, Valencia, España; Departamento de Cirugía, Universidad de Valencia, Valencia, España
| | - Isabel Mora-Oliver
- Unidad de Cirugía Endocrina y Bariátrica, Servicio de Cirugía General y del Aparato Digestivo, Hospital Clínico Universitario de Valencia, Valencia, España
| | - Norberto Cassinello-Fernández
- Unidad de Cirugía Endocrina y Bariátrica, Servicio de Cirugía General y del Aparato Digestivo, Hospital Clínico Universitario de Valencia, Valencia, España; Departamento de Cirugía, Universidad de Valencia, Valencia, España
| | - Joaquín Ortega-Serrano
- Unidad de Cirugía Endocrina y Bariátrica, Servicio de Cirugía General y del Aparato Digestivo, Hospital Clínico Universitario de Valencia, Valencia, España; Departamento de Cirugía, Universidad de Valencia, Valencia, España.
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Granel Villach L, Laguna Sastre JM, Ibáñez Belenguer JM, Beltrán Herrera HA, Queralt Martín R, Fortea Sanchis C, Martínez Ramos D, Escrig Sos VJ. Analysis of the impact of bariatric surgery on medium-term pharmacological expenditure. Cir Esp 2020; 99:S0009-739X(20)30379-1. [PMID: 33358406 DOI: 10.1016/j.ciresp.2020.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 09/26/2020] [Accepted: 11/06/2020] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Obesity and associated diseases represent an important health and economic problem since pharmacological treatment for many of these pathologies needs lifelong subsidies. Theoretically, bariatric and metabolic surgery decreases the medication requirements of patients for these diseases but may result in other types of pharmacological needs. This study aims to demonstrate whether there is a real decrease in pharmacological expenditure after bariatric surgery. MATERIAL AND METHODS Retrospective cross-sectional analysis of patients who were treated in our centre between 2012 and 2016, comparing different associated comorbidities and pharmacological expenses one month before and 2years after surgery. RESULTS 400 patients were operated. The results were presented, showing the differences between the resolution of the different comorbidities and the pharmacological savings generated for each of the surgical techniques studied. The most cost-effective comorbidity in the study was type2 diabetes mellitus (DM2). The surgical technique with the best results was metabolic bypass, presenting a cost difference after surgery of 507euros per month (P<.001). CONCLUSIONS In a 2-year follow-up after bariatric surgery, a decreased prevalence of obesity-related diseases and associated pharmacological expenditure was observed, showing the efficiency of this intervention over the medium term.
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Affiliation(s)
- Laura Granel Villach
- Cirugía General y del Aparato Digestivo, Hospital General Universitario de Castellón, Castellón, España.
| | - José Manuel Laguna Sastre
- Cirugía General y del Aparato Digestivo, Hospital General Universitario de Castellón, Castellón, España; Universitat Jaume I, Castellón, España
| | | | | | - Raquel Queralt Martín
- Cirugía General y del Aparato Digestivo, Hospital General Universitario de Castellón, Castellón, España
| | - Carlos Fortea Sanchis
- Cirugía General y del Aparato Digestivo, Hospital General Universitario de Castellón, Castellón, España
| | - David Martínez Ramos
- Cirugía General y del Aparato Digestivo, Hospital General Universitario de Castellón, Castellón, España
| | - Vicente Javier Escrig Sos
- Cirugía General y del Aparato Digestivo, Hospital General Universitario de Castellón, Castellón, España; Universitat Jaume I, Castellón, España
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Ruiz de Angulo D, Balaguer Román A, Munitiz Ruiz V, Gil Vázquez PJ, Ruiz Merino G, Ortiz Escandell MÁ, Martínez de Haro LF, Parrilla Paricio P. Influence of the lockdown due to COVID-19 on weight-loss results during the first year after sleeve gastrectomy. Cir Esp 2020; 99:428-432. [PMID: 34629481 PMCID: PMC7428729 DOI: 10.1016/j.ciresp.2020.08.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Accepted: 08/04/2020] [Indexed: 11/16/2022]
Abstract
Introducción La pandemia por COVID-19 ha obligado al confinamiento de la población en muchos países. En España, el estado de alarma se estableció desde el 15 de marzo al 20 de junio del 2020. Este hecho, por lo general, disminuyó la movilidad y la actividad física de las personas, además de producir o exacerbar alteraciones psicológicas. Nuestro objetivo es analizar la influencia que esta situación ha ejercido sobre los resultados ponderales a corto plazo de los pacientes tratados mediante una gastrectomía vertical laparoscópica entre mayo del 2019 y mayo del 2020. Métodos Estudio de casos y controles donde se compararon el porcentaje de exceso de peso perdido (%EWL) y el porcentaje de peso total perdido (%TWL) de los pacientes intervenidos en el último año y a los que ha afectado el confinamiento durante el mes de abril y parte de marzo del 2020 (grupo 1; n = 20), con el de un grupo control (grupo 2; n = 40) de nuestra casuística previa. Resultados El %EWL medio en el grupo 1 es de 47,37 ± 18,59 y en el grupo 2 es de 51,13 ± 17,59, siendo la p = 0,438. Por su parte, el %TWL medio en el grupo 1 es de 21,14 ± 8,17 mientras que en el grupo 2 es de 24,67 ± 8,01, resultando la p = 0,115. Conclusiones El confinamiento de la población por COVID-19 no empeoró los resultados ponderales a corto plazo de la gastrectomía vertical. Son necesarios más estudios con un mayor número de pacientes para obtener conclusiones más sólidas.
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Affiliation(s)
- David Ruiz de Angulo
- Unidad de Cirugía Esofagogástrica y Obesidad, Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario Virgen de la Arrixaca, Murcia, España.
| | - Andrés Balaguer Román
- Servicio de Cirugía General y Aparato Digestivo, Hospìtal Universitario Virgen de la Arrixaca, Murcia, España
| | - Vicente Munitiz Ruiz
- Unidad de Cirugía Esofagogástrica y Obesidad, Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario Virgen de la Arrixaca, Murcia, España
| | - Pedro José Gil Vázquez
- Servicio de Cirugía General y Aparato Digestivo, Hospìtal Universitario Virgen de la Arrixaca, Murcia, España
| | | | - M Ángeles Ortiz Escandell
- Unidad de Cirugía Esofagogástrica y Obesidad, Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario Virgen de la Arrixaca, Murcia, España
| | - Luisa F Martínez de Haro
- Unidad de Cirugía Esofagogástrica y Obesidad, Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario Virgen de la Arrixaca, Murcia, España
| | - Pascual Parrilla Paricio
- Unidad de Cirugía Esofagogástrica y Obesidad, Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario Virgen de la Arrixaca, Murcia, España
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Abstract
The purpose of this review is to provide an update on the changing face of paediatric type 1 diabetes and type 2 diabetes. Paediatric diabetes is on the rise, with extensive research dedicated to understanding its pathophysiology, comorbidities and complications. As obesity continues to increase among all youth, differentiating between type 1 diabetes and type 2 diabetes has become increasingly difficult but remains important for optimising treatment, anticipating complications and predicting disease risk. Novel treatments are emerging, with the ultimate goal being to achieve glycaemic control, limit weight gain, improve quality of life and reduce comorbidities. In this review, we focus on updates regarding the epidemiology, clinical presentation, comorbidities and complications of paediatric type 1 diabetes and type 2 diabetes and conclude with current and emerging treatments.
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Affiliation(s)
- Amy S Shah
- University of Cincinnati, Department of Pediatrics, Cincinnati, OH, USA.
- Cincinnati Children's Hospital Medical Center, Division of Endocrinology, 3333 Burnet Ave, ML 7012, Cincinnati, OH, 45229, USA.
| | - Kristen J Nadeau
- University of Denver, Department of Pediatrics, Aurora, CO, USA
- Children's Hospital Colorado, Division of Endocrinology, Aurora, CO, USA
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Rodicio Miravalles JL, Alonso Fernández J, Moreno Gijón M, Rizzo Ramos A, Turienzo Santos E, Sanz Álvarez L, Rodríguez García JI, González González JJ. Economic evaluation of surgical treatment of obesity. Cir Esp 2020; 98:381-388. [PMID: 32139086 DOI: 10.1016/j.ciresp.2020.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2019] [Revised: 11/24/2019] [Accepted: 01/13/2020] [Indexed: 10/24/2022]
Abstract
INTRODUCTION Obesity surgery is the best treatment for extreme obesity, with demonstrated long-term positive outcomes. The potential cost-savings generated by the improvement of comorbidities after surgery can justify the allocation of more resources in the surgical treatment of obesity. METHODS This was an observational, descriptive, longitudinal and retrospective study. Eligible patients underwent Roux-en-Y gastric bypass surgery at the Hospital Universitario Central de Asturias between 2003 and 2012. The established minimum follow-up period was two years. We calculated the individualized cost per patient treated (bottom-up) as well as per Diagnosis-Related Group (DRG) codes (top-down). RESULTS Our study included 307 patients. The average cost per hospitalization calculated by DRG codes was €6,545.90, and the average cost per patient was €10,572.20. DRG 288 represented 91% of the series, with a value of €4,631. The number of medications also decreased during this period, from 2.86 to 0.78 per medically treated patient, representing a cost reduction of €4,433 per patient with all the obesity-related comorbidities analyzed. CONCLUSIONS Two years after Roux-en-Y gastric bypass conducted at Hospital Universitario Central de Asturias, the savings in drug costs for patients with multiple pathologies would compensate the inherent costs of the surgical treatment itself. Our results showed that DRG-related costs was insufficient to make a correct economic evaluation, so we recommend an individualized cost calculating method.
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Affiliation(s)
| | | | - María Moreno Gijón
- Servicio de Cirugía General, Hospital Universitario Central de Asturias, Oviedo, España
| | - Amaya Rizzo Ramos
- Servicio de Cirugía General, Hospital Universitario Central de Asturias, Oviedo, España
| | | | - Lourdes Sanz Álvarez
- Servicio de Cirugía General, Hospital Universitario Central de Asturias, Oviedo, España
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Vives M, Molina A, Danús M, Rebenaque E, Blanco S, París M, Sánchez A, Sabench F, Del Castillo D. Analysis of Gastric Physiology After Laparoscopic Sleeve Gastrectomy (LSG) With or Without Antral Preservation in Relation to Metabolic Response: a Randomised Study. Obes Surg 2018; 27:2836-2844. [PMID: 28478583 DOI: 10.1007/s11695-017-2700-z] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
INTRODUCTION Laparoscopic sleeve gastrectomy is one of the most common techniques in bariatric surgery, but there is no consensus on the optimal distance from the pylorus to start the gastric transection. The aim of this study is to determine the differences in gastric emptying, gastric distension and metabolic response between two starting distances. MATERIAL AND METHODS This is a prospective randomised study of 60 patients (30 patients with the section at 3 cm and 30 patients at 8 cm from the pylorus). We calculate at 6 and 12 months from surgery gastric emptying by scintigraphy (T1/2 min), gastric volume by CT scan (cc) and metabolic response by blood sample analysis (glucose, HbA1c, insulin, HOMA-IR, GLP-1, GIP and C-peptide). RESULTS Gastric emptying increases the speed significantly in both groups but is greater in the 3-cm group (p < 0.05). Dividing groups into type 2 diabetic patients and non-diabetic patients, the speed in non-diabetic patients is significantly higher for the 3-cm group. Residual volume increases significantly in both groups, and there are no differences between them. One year after surgery, there are significant improvements in the hyperinsulinaemia in the patients of the 3-cm group with respect to the 8-cm group, but only in diabetic patients. No differences between groups are found regarding changes in GLP-1 or GIP. CONCLUSIONS Gastric emptying is faster in patients with antrum resection. The distance does not influence the gastric emptying of diabetic patients. Other mechanisms may explain metabolic response besides GLP-1 and its association with improvements in diabetes via gastric emptying.
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Affiliation(s)
- M Vives
- Surgery Service, University Hospital of Sant Joan, Faculty of Medicine, IISPV, "Rovira i Virgili" University, Reus, Tarragona, Spain
| | - A Molina
- Surgery Service, University Hospital of Sant Joan, Faculty of Medicine, IISPV, "Rovira i Virgili" University, Reus, Tarragona, Spain
| | - M Danús
- Nuclear Medicine Service, University Hospital of Sant Joan, Faculty of Medicine, IISPV, "Rovira i Virgili" University, Reus, Tarragona, Spain
| | - E Rebenaque
- Radiology Service, University Hospital of Sant Joan, Faculty of Medicine, IISPV, "Rovira i Virgili" University, Reus, Tarragona, Spain
| | - S Blanco
- Surgery Service, University Hospital of Sant Joan, Faculty of Medicine, IISPV, "Rovira i Virgili" University, Reus, Tarragona, Spain
| | - M París
- Surgery Service, University Hospital of Sant Joan, Faculty of Medicine, IISPV, "Rovira i Virgili" University, Reus, Tarragona, Spain
| | - A Sánchez
- Surgery Service, University Hospital of Sant Joan, Faculty of Medicine, IISPV, "Rovira i Virgili" University, Reus, Tarragona, Spain
| | - F Sabench
- Surgery Service, University Hospital of Sant Joan, Faculty of Medicine, IISPV, "Rovira i Virgili" University, Reus, Tarragona, Spain.
| | - D Del Castillo
- Surgery Service, University Hospital of Sant Joan, Faculty of Medicine, IISPV, "Rovira i Virgili" University, Reus, Tarragona, Spain.
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Sanchez-Santos R, Padin EM, Adam D, Borisenko O, Fernandez SE, Dacosta EC, Fernández SG, Vazquez JT, de Adana JCR, de la Cruz Vigo F. Bariatric surgery versus conservative management for morbidly obese patients in Spain: a cost-effectiveness analysis. Expert Rev Pharmacoecon Outcomes Res 2017; 18:305-314. [PMID: 29188745 DOI: 10.1080/14737167.2018.1407649] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
BACKGROUND We assessed the cost-effectiveness of bariatric surgery (BS) versus conservative management (CM) for treating morbid obesity in Spain. METHODS We developed a probabilistic Markov model to estimate health outcomes, quality-adjusted life years (QALY), life years gained (LYG), and costs over lifetime and 10-year horizons. Combined common BS procedures were compared with CM. Clinical and utility inputs were obtained from the literature and resource use and costs from local sources (€2017). RESULTS Over the 10-year horizon, BS led to a cost increment of €9,386 and 1.6 additional QALY (€5,966/QALY). Leading to 0.6 LYG and 4.4 QALY gains and €300/patient average cost savings over lifetime, BS could potentially significantly reduce diabetes and cardiovascular disease risk over the considered horizons. Despite short-term cost reductions, surgery delay may lead to significant clinical benefits loss. CONCLUSIONS Compared to CM, BS is a more effective and less costly alternative for treating morbid obesity in Spain.
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Affiliation(s)
- Raquel Sanchez-Santos
- a General and Digestive Surgery Department , Complejo Hospitalario de Pontevedra, Instituto de Investigación Galicia Sur , Pontevedra , Spain
| | - Esther Mariño Padin
- b General and Digestive Surgery Department , Complejo Hospitalario de Pontevedra , Pontevedra , Spain
| | - Daniel Adam
- c Health Economics Department , Synergus AB , Danderyd , Sweden
| | - Oleg Borisenko
- c Health Economics Department , Synergus AB , Danderyd , Sweden
| | - Sergio Estevez Fernandez
- d General and Digestive Surgery Department , Complejo Hospitalario Universitario de Pontevedra , Pontevedra , Spain
| | - Ester Carrera Dacosta
- d General and Digestive Surgery Department , Complejo Hospitalario Universitario de Pontevedra , Pontevedra , Spain
| | - Sonia González Fernández
- b General and Digestive Surgery Department , Complejo Hospitalario de Pontevedra , Pontevedra , Spain
| | - Juan Turnes Vazquez
- e Digestive System Department , Instituo de investigación Galicia Sur , Pontevedra , Spain
| | | | - Felipe de la Cruz Vigo
- g General and Digestive Surgery Department , Hospital Universitario 12 de Octubre , Madrid , Spain
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The Inequity of Bariatric Surgery: Publicly Insured Patients Undergo Lower Rates of Bariatric Surgery with Worse Outcomes. Obes Surg 2017; 28:44-51. [DOI: 10.1007/s11695-017-2784-5] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Sheng B, Feng C, Zhang D, Spitler H, Shi L. Associations between Obesity and Spinal Diseases: A Medical Expenditure Panel Study Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:E183. [PMID: 28208824 PMCID: PMC5334737 DOI: 10.3390/ijerph14020183] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/07/2016] [Revised: 01/03/2017] [Accepted: 01/19/2017] [Indexed: 01/02/2023]
Abstract
Background: The link between body weight status and spinal diseases has been suggested by a number of cross-sectional and cohort studies with a limited range of patient populations. No population-representative samples have been used to examine the link between obesity and spinal diseases. The present study is based on a nationally representative sample drawn from the Medical Expenditure Panel Survey. Methods: Using the cross-sectional sample of the 2014 Medical Expenditure Panel Study, we built four weighted logistic regression analyses of the associations between body weight status and the following four spinal diseases: low back pain, spondylosis, other cervical disorders and intervertebral disc disorder (IDD). Each respondent's body weight status was used as the key independent variable with three categories: normal/underweight, overweight, and obese. We controlled for marital status, gender, age, smoking status, household income, health insurance coverage, educational attainment and the use of health services for other major categories of diseases. Results: A total sample of 23,048 respondents was used in our analysis. Overweight and obese respondents, as compared to normal/underweight respondents, were more likely to develop lower back problems (Overweight: logged odds = 0.218, p < 0.01; Obese: logged odds = 0.395, p < 0.001) and IDD (Overweight: logged odds = 0.441, p < 0.05; Obese: logged odds = 0.528, p < 0.001). The associations between bodyweight status and spondylitis were statistically insignificant (Overweight: logged odds = 0.281, p = 0.442; Obese: logged odds = 0.680, p = 0.104). The associations between body weight status and other cervical disorders (Overweight: logged odds = -0.116, p = 0.304; Obese: logged odds = -0.160, p = 0.865) were statistically insignificant. Conclusions: As the first study using a national sample to study bodyweight and spinal diseases, our paper supports the hypothesis that obesity adds to the burden of low back pain and IDD. Longitudinal and interventional studies are needed to understand the specific mechanisms behind these positive associations.
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Affiliation(s)
- Binwu Sheng
- First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China.
| | - Chaoling Feng
- Samuel Curtis Johnson Graduate School of Management, Cornell University, Ithaca, NY 14853, USA.
| | - Donglan Zhang
- Department of Health Policy and Management, University of Georgia, Athens, GA 30609, USA.
| | - Hugh Spitler
- Department of Public Health Sciences, Clemson University, Clemson, SC 29631, USA.
| | - Lu Shi
- Department of Public Health Sciences, Clemson University, Clemson, SC 29631, USA.
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Frois C, Cremieux PY. For a Step Change to Curb the Obesity Epidemic. PHARMACOECONOMICS 2015; 33:613-617. [PMID: 26068946 DOI: 10.1007/s40273-015-0303-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Affiliation(s)
- Christian Frois
- Analysis Group, Inc., 111 Huntington Avenue, Tenth Floor, Boston, MA, 02199-7668, USA
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Ribeiro EF, de Ávila RI, de Sousa Santos RR, Garrote CFD. Impact of Bariatric Surgery on Patients from Goiás, Brazil, Using the BAROS Method - A Preliminary Study. GE-PORTUGUESE JOURNAL OF GASTROENTEROLOGY 2015; 22:93-102. [PMID: 28868385 PMCID: PMC5580192 DOI: 10.1016/j.jpge.2015.03.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/07/2014] [Accepted: 03/13/2015] [Indexed: 12/25/2022]
Abstract
Introduction As obesity is currently a major public health problem, bariatric surgery has been widely indicated due to the difficulties involved in the clinical management of obese adults. Objectives Assess the quality-of-life (QOL) of patients who had undergone Roux-en-Y Gastric Bypass (RYGB) in the State of Goiás, Brazil, where as yet no studies have been published on the QOL of patients who underwent bariatric surgery. Methods A retrospective study, using the Bariatric Analysis and Reporting Outcome System (BAROS), was carried out in Goiânia and Rio Verde, Goiás, Brazil, with 50 over 18-year-old patients of both genders, who had undergone RYGB and had at least three months of postoperative time. Results Before RYGB, 48% of the individuals were classified as morbidly obese. Average weight and body mass index (BMI) of the 50 patients interviewed were 119.37 ± 18.44 kg and 43.54 ± 5.33 kg/m2, respectively. By contrast, after the RYGB these parameters decreased significantly to 78.01 ± 11.06 kg and 28.46 ± 3.61 kg/m2, respectively, mainly from the 3rd to 85th month of postoperative time (p < 0.0001). As well as that, 78% reported having presented preoperative comorbidities, especially hypertension (44%), rheumatism (34%), dyslipidemia (24%) and diabetes (20%). However, after surgery, the resolution rates were 77, 24, 100 and 100%, respectively, for these same clinical conditions. In terms of QOL, some patients reported feeling better (8%) or much better (92%) after RYGB. The outcome of the BAROS method for those patients was classified as fair (2%), good (8%), very good (24%) and excellent (66%). Conclusions Preliminary results indicated that RYGB could be a successful surgical procedure to promote satisfactory and sustained reduction in the body measurements of morbidly obese patients from Goiás, Brazil. Furthermore, the final BAROS score showed improvements in associated comorbidity and also in the QOL of these patients.
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14
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Linkov F, Bovbjerg DH, Freese KE, Ramanathan R, Eid GM, Gourash W. Bariatric surgery interest around the world: what Google Trends can teach us. Surg Obes Relat Dis 2013; 10:533-8. [PMID: 24794184 DOI: 10.1016/j.soard.2013.10.007] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2013] [Revised: 09/27/2013] [Accepted: 10/12/2013] [Indexed: 01/28/2023]
Abstract
BACKGROUND Bariatric surgery may prove an effective weight loss option for those struggling with severe obesity, but it is difficult to determine levels of interest in such procedures at the population level through traditional approaches. Analysis of Google Trend information may give providers and healthcare systems useful information regarding Internet users' interest in bariatric procedures. The objective of this study was to gather Google Trend information on worldwide Internet searches for "bariatric surgery", "gastric bypass", "gastric sleeve", "gastric plication", and "lap band" from 2004-2012 and to explore temporal relationships with relevant media events, economic variations, and policy modifications. METHODS Data were collected using Google Trends. Trend analyses were performed using Microsoft Excel Version 14.3.5 and Minitab V.16.0. RESULTS Trend analyses showed that total search volume for the term "bariatric surgery" has declined roughly 25% since January 2004, although interest increased approximately 5% from 2011 to 2012. Interest in lap band procedures declined 30% over the past 5 years, while "gastric sleeve" has increased 15%. Spikes in search numbers show an association with events such as changing policy and insurance guidelines and media coverage for bariatric procedures. CONCLUSION This report illustrates that variations in Internet search volume for terms related to bariatric surgery are multifactorial in origin. Although it is impossible to ascertain if reported Internet search volume is based on interest in potentially undergoing bariatric surgery or simply general interest, this analysis reveals that search volume appears to mirror real world events. Therefore, Google Trends could be a way to supplement understanding about interest in bariatric procedures.
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Affiliation(s)
- Faina Linkov
- Department of Obstetrics, Gynecology, & Reproductive Sciences, Department of Obstetrics, Gynecology, & Reproductive Sciences, Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania.
| | - Dana H Bovbjerg
- University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania
| | - Kyle E Freese
- Department of Obstetrics, Gynecology, & Reproductive Sciences, Department of Obstetrics, Gynecology, & Reproductive Sciences, Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania
| | - Ramesh Ramanathan
- Division of General Surgery, University of Pittsburgh Physicians, Pittsburgh, Pennsylvania
| | - George Michel Eid
- Division of General Surgery, University of Pittsburgh Physicians, Pittsburgh, Pennsylvania
| | - William Gourash
- Department of Minimally Invasive Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
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