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A retrospective case‐control cohort analysis of comorbidity and health expenditure in hospitalized adults diagnosed with obesity utilizing ICD ‐10 diagnostic coding
Author(s) -
Bishay Ramy H.,
MeyerowitzKatz G.,
Hng T. M.,
Colaco C. M. G.,
Khanna S.,
Klein R.,
Sanjeev D.,
McLean M.,
Ahlenstiel G.,
Maberly G. F.
Publication year - 2021
Publication title -
clinical obesity
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.64
H-Index - 12
eISSN - 1758-8111
pISSN - 1758-8103
DOI - 10.1111/cob.12469
Subject(s) - medicine , obesity , comorbidity , retrospective cohort study , cohort , medical record , diagnosis code , pediatrics , emergency medicine , population , environmental health
Summary The cost and comorbidity of obesity in hospitalized inpatients, is less known. A retrospective study of patients presenting to a large district hospital in Western Sydney (April 2016‐February 2017) using clinical, pathological as well as diagnostic coding data for obesity as per ICD‐10. Of 43 212 consecutive hospital presentations, 390 had an obesity‐coded diagnosis (Ob, 0.90%), of which 244 were gender and age‐matched to a non‐obesity coded cohort (NOb). Weight and BMI were higher in the Ob vs NOb group (126 ± 37 vs 82 ± 25 kg; BMI 46 ± 12 vs 29 ± 8 kg/m 2 , P < .001) with a medical record documentation rate of 62% for obesity among Ob. The Ob cohort had 2‐5× higher rates of cardiopulmonary and metabolic complications ( P < .001), greater pharmacologic burden, length of stay (LOS, 225 vs 89 hours, P < .001) and stay in intensive care but no differences in the prevalence of mental disorders. Compared with BMI <35 kg/m 2 , inpatients with BMI >35 kg/m 2 were 5× more likely to require intensive care (OR 5.08 [1.43‐27.3, 95% CI], P = .0047). The initiation of obesity‐specific interventions by clinical teams was very low. People with obesity who are admitted to hospital carry significant cost and complications, yet obesity is seldom recognized as a clinical entity or contributor.