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2010 Report

frontpageExecutive summary

This is the first comprehensive, prospective, nationwide analysis of outcomes from bariatric (obesity) surgery in the United Kingdom & Ireland:

In overview:

• 84 surgeons from 86 hospitals recorded 8,710 operations; 7,045 in the financial years 2009 & 2010.

• 68.8% operations were funded by the National Health Service; 30.9% were independently funded and a tiny proportion were paid for by private insurers.

• Data are analysed for 3,817 gastric bypass procedures, 2,132 gastric band operations and 588 sleeve gastrectomy operations.

• The observed in-hospital mortality rate after primary surgery was 0.1% overall (and just 0.2% for gastric bypass), much lower than that for many other planned operations.

• The recorded surgical complication rate overall for primary operations was 2.6 %.

• These figures compare to the best internationally available outcome benchmarks. Thus, surgery in the United Kingdom & Ireland, in the hands of the contributors, is safe.

• 80% of patients were discharged by the third post-operative day, indicating the efficient use of resource.

At the time of primary surgery:

• 24.9% of all patients had a high level of co-existing disease.

• 27.5% had type 2 diabetes

• 16.5% were on treatment for sleep apnoea.

• 69.0% of all patients had some functional impairment, i.e., they could not manage to climb 3 flights of stairs without resting.

Follow-up data is derived from some 12,000 follow-up entries for the 2009 & 2010 patients

One year after surgery:

• On average, patients lost 57.8% of their excess weight (43.2% for gastric banding, 67.8% for gastric bypass & 54.0% for sleeve gastrectomy).

• Almost half of patients with pre-operative functional impairment returned to a state of no impairment one year after surgery, meaning they could climb 3 flights of stairs without resting.

• 60.2% of patients with sleep apnoea were able to come off treatment.

Two years after surgery:

• 85.5% of patients with type 2 diabetes returned to a state of no indication of diabetes, meaning, in practice, that they were able to stop their diabetic medications.

Healthcare implications:

• Severe & Complex Obesity is a serious, life-long condition associated with many major medical conditions, the cost of which threatens to bankrupt the NHS. Once established in adults it constitutes a dysregulated state of physiology and reversal is not primarily a voluntary or behavioural process.

• Among comparisons of age, weight, level of co-morbidity, gender, etc., the data also show that the benefit for certain co-morbidities is greater the earlier surgical treatment is undertaken. This has implications for the prioritisation of treatment.

• Bariatric surgery greatly and highly cost-effectively improves the health of obese patients, much more so than other treatments.

 

 

The document is available as a free pdf download to AUGIS and BOMSS members via: www.e-dendrite.com/nbsr Additional copies may be purchased online from Dendrite’s e-bookshop: www.e-dendrite.com/publishing/reports

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