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Diagnosed with type 2 diabetes, a high cholesterol and high blood pressure limit, Dana Hayes pursued bariatric surgery in the hope of leading a longer life healthy
"I fought all my life. Hayes, 30, a hairdresser and mother of four, says. She waited five months before being operated on after her first clinic appointment
This wait is not uncommon: Eligible patients are increasingly faced with waiting times longer for proven operations allowing them to lose weight safely. their health, according to a new study published in Annals of Surgery .
In the first multi-institutional review of waiting times for bariatric surgery in the United States, surgeons reviewed data collected by the Michigan Bariatric Surgery. Collaborative (MBSC) on 60,791 patients who had bariatric surgery in Michigan
In 2006, patients generally had their bariatric surgery 86 days after their first visit to the clinic. In 2016, wait times nearly doubled to 159 days.
"Long wait times can be daunting and increase the chances that patients will give up their surgery," says study author Oliver Varban, MD, of the University of Toronto. Michigan and director of the Adult Bariatric Surgery Program. He also carried out the Hayes operation.
Since more surgeons began practicing bariatric surgery in Michigan in the last decade, finding a doctor available has had minimal impact on sequencing, the authors said
The researchers used the data to create two study groups: a shorter waiting group with a median wait of 67 days and a longer wait group that waited for the first time. days or more for surgery.
in the longer waiting group had lost 56.6 pounds compared to the shorter waiting group in which the average weight loss was 58.9 pounds.
Patients with complex medical histories enrolled in Medicaid experienced the longest delays. Non-white patients also waited longer, but in Michigan, they are more often enrolled in Medicaid.
Smokers and patients suffering from hypercholesterolemia or psychological disorders also had longer waiting times for bariatric surgery
. being: Among all recipients, serious complications occurred in only 2% of patients the first month after the intervention
Why do patients have longer waiting times to undergo bariatric surgery? only for surgeries to treat other life-threatening diseases? A big reason: Many insurance companies ask them to lose weight before surgery, even if no data or evidence proves that preoperative weight loss affects long-term success.
Some insurers, including Medicaid, want documentation of supervised diet attempts. Patients can lose weight and improve their health, but the benefits will not last unless patients can keep their weight.
"Patients who wait longer have fewer complications or better comorbidity. Time argues for streamlining the process of preoperative optimization and against weight loss documentation mandated by insurance, "says Rafael Alvarez, MD, lead author of the study.
The mandates of insurers may cause a delay in care. say, and such policies should be reconsidered considering their uncertain benefit to patients.
A Push for Timely Intervention
Members of the study team recognize that their data can not measure attitudes or doubts. 19659003] Cautious physicians may overestimate the risk of surgery, and patients may experience cold feet and intentionally delay surgery. And the study has not been able to measure the availability of other specialists, such as dietitians, who are needed to guide patients through a successful health transformation.
Even without the specific details of the practice, the work led by UM surgeons is the most robust review of waiting times for bariatric surgery in the United States
About 95 percent of patients undergoing a bariatric surgery in Michigan are listed in the MBSC registry used for the study.
the intention to recognize practice trends and patient outcomes in a way that only a single doctor or even a hospital would be able to do by itself – to find out if the Appropriate patients receive timely bariatric surgery.
285 pounds, Hayes lost 30 pounds in just over two months after a gastric sleeve surgery. His recovery was without event. She returned to work in two weeks
. The steady decline in weight has given Hayes a welcome boost for energy at work and in family life. His blood sugar level is normal.
And Hayes spoke to a dietitian about how to get adequate nutrition now that she consumes less food.
"My only regret," she says, "is that I did not do it the sooner. "
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