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CHARACTERISTICS AND TRENDS IN BARIATRIC SURGERY IN THE U.S., 1999-2004, AND A COMPARISON OF SURGICAL PATIENTS TO THOSE ELIGIBLE FOR SURGERY

Leishear, Kira (2009) CHARACTERISTICS AND TRENDS IN BARIATRIC SURGERY IN THE U.S., 1999-2004, AND A COMPARISON OF SURGICAL PATIENTS TO THOSE ELIGIBLE FOR SURGERY. Master's Thesis, University of Pittsburgh. (Unpublished)

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Abstract

Severe obesity (BMI >= 40 kg/m2) increases risk for many diseases (e.g., hypertension, diabetes). Bariatric surgery is the treatment with the greatest long-term success for severe obesity, sustaining weight loss and improving health. The number of bariatric surgeries has increased tremendously in recent years, although the percentage of adults eligible for surgery that receive the surgery is very small. Using the National Hospital Discharge Survey (1999-2004), patient, surgical, and hospital characteristics were analyzed over this six year time period. Using the National Health and Nutrition Examination Survey (NHANES), severely obese adults were compared to bariatric surgical patients with respect to age, sex, and health insurance for the years 2003 and 2004. Chi-square tests were used to test for differences in characteristics, and tests for trend were performed to test for temporal trends. Poisson regression was used to model length of hospital stay. From 1999 to 2004, most bariatric surgical patients were 30-49 years old, female, and were expected to pay with private insurance only. The most common comorbidities among bariatric surgical patients were hypertension (45.5%), sleep apnea (25.8%), and diabetes (21.8%). The majority of bariatric surgeries performed were high gastric bypasses. The number of bariatric surgeries increased more than 15-fold from 2000 to 2003. Length of hospital stay decreased from 1999 to 2004. Those who had gastroplasty were more likely to have a shorter hospital stay compared to other procedures.Only about 2.3% of severely obese individuals in the United States received bariatric surgery in 2003-2004. Males, younger and older adults, and those with public insurance were under-represented among bariatric surgical patients in 2003 and 2004. Because obesity is a major public health concern, discrepancies in characteristics of adults who are eligible for bariatric surgery compared to those receiving the surgery need to be addressed. Clinical practices should make sure everyone eligible is aware and well-informed of bariatric surgery. Healthcare policies should eventually allow every candidate the choice of having bariatric surgery, to improve health and reduce healthcare costs.


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Details

Item Type: University of Pittsburgh ETD
Status: Unpublished
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Leishear, Kirakiralei@aol.com
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee ChairBelle, Steven Hbelle@edc.pitt.eduSBELLE
Committee MemberYouk, Ada Oayouk@pitt.eduAYOUK
Committee MemberKing, Wendy Ckingw@edc.pitt.eduWCK1
Date: 29 January 2009
Date Type: Completion
Defense Date: 7 August 2008
Approval Date: 29 January 2009
Submission Date: 24 October 2008
Access Restriction: 5 year -- Restrict access to University of Pittsburgh for a period of 5 years.
Institution: University of Pittsburgh
Schools and Programs: Graduate School of Public Health > Biostatistics
Degree: MS - Master of Science
Thesis Type: Master's Thesis
Refereed: Yes
Uncontrolled Keywords: bariatric surgery; chi-square; NHANES; NHDS; Poisson regression; severe obesity; tests for trend
Other ID: http://etd.library.pitt.edu/ETD/available/etd-10242008-160733/, etd-10242008-160733
Date Deposited: 10 Nov 2011 20:03
Last Modified: 15 Nov 2016 13:50
URI: http://d-scholarship.pitt.edu/id/eprint/9511

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