Many Complications for Obesity Surgery

July 24, 2006 -- Four in 10 obesitysurgery patients develop complications within six months of leaving the hospital -- and 18% require a new hospital visit, a federal study shows.

The 40% complication rate is far higher than the 10% to 20% complication rate for most surgeries. And it is higher than previously reported rates for obesity surgery, as most earlier studies looked only at 30-day data.

William E. Encinosa, PhD, along with colleagues at the U.S. Health & Human Service's Agency for Healthcare Research and Quality (AHRQ), looked at private insurance claims filed for 2,522 obesity surgeries at 308 hospitals in 49 states.

They found that about 22% of patients had complications within 30 days of leaving the hospital. But by 180 days, this rate had jumped by 81%. More than 18% of patients needed some kind of hospital visit after their initial surgical stay.

The most common complications for patients:

• About 20% had dumping, which includes vomiting, reflux, and diarrhea.
• 12% had complications from the surgical joining of the stomach and intestine -- usually leaking or stricture.
• 7% had abdominal hernias.
• 6% had infections.
• 4% had pneumonia.

If this sounds scary, it is. But it's not as scary as living with morbid obesity. Studies suggest obesity surgery cuts a person's risk of death by nearly 90%. Three percent of under-40 obesity surgery patients die within 13.6 years -- far fewer than the nearly 14% who die without the surgery.

"Obesity surgery is helping thousands of Americans who have not succeeded at losing weight reduce their risk of diabetesand other life-threatening diseases," AHRQ director Carolyn M. Clancy, MD, said in a news release. "But this study shows how important it is for patients to consider the potential complications when they make the decision to undergo the procedure."

Obesity surgery also may end up costing more than people expect. If everything goes well, Encinosa's team found, the cost of the surgery averages $27,125. But if a patient has to be re-hospitalized within six months, the average cost rises to $65,031.

The study appears in the August issue of the journal Medical Care.