The Effect of BMI on Common GI Procedures: Preliminary Data of a Large Prospective Observational Study: ACG Obesity Award

Abstract

Purpose: According to a recent CDC report, more than one third of Americans are overweight or obese and obesity effects alone cost the healthcare system an astounding 147 billion dollars annually. The effect of obesity on safety and increased cost of common endoscopic procedures has not been well examined. The purpose of this study is to investigate the role of obesity with regards to safety and cost in patients undergoing Esophagoduodenoscopy (EGD) and colonoscopy (CF). Methods: After IRB approval, we created a data bank from the records of all patients undergoing CF or EGD. A preliminary analysis was conducted for the first 3 month period from Feb 1, 2011 to April 30, 2011. Patients undergoing combined procedures were excluded. We tabulated multiple variables including weight, height, indications of procedure, anesthetic used, duration of procedure, duration for recovery, and complications. We performed a bivariate regression analysis of all the data to determine the association of obesity (increasing BMI) with early termination, length of procedures, and recovery time from anesthesia. Results: During the specified time period, 395 patients who met inclusion criteria underwent EGD. Of these, 139 (35.2%) had a BMI <25, and 220 (64.8%) had a BMI >25. While there was no statistically significant difference in premature termination or length of procedure, the recovery time from anesthesia in patients with BMI >25 was longer (11.8 minutes vs 10.55 minutes, P value 0.012). During the same period, 549 patients underwent CF; 147 (27%) had a BMI <25 while 402 (73%) had a BMI >25. Patients with BMI > 25 were significantly more likely to require repeat procedures due to premature termination of the first procedure. (OR: 2.95; CI 1.43 to 6.09). There was no statistically significant difference in the procedure time or recovery time from anesthesia. Conclusion: Overweight and obese patients require repeat colonoscopies due to incomplete first procedures more frequently and require a longer recovery period after EGD. These findings translate into potentially staggering costs for the healthcare system. Further studies are warranted to investigate potential measures to mitigate obesity related healthcare costs in GI procedures.Table: EGDTable: Colonoscopy