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A MULTIDISCIPLINARY, OBESITY-FOCUSED APPROACH IMPROVES DIAGNOSIS OF OBESITY-RELATED ILLNESSES: A NEW PARADIGM FOR THE CARE OF PATIENTS WITH OBESITY

Roderick Olivas, Aaron Brown, MD, Racquel S Bueno, MD, Cedric S Lorenzo, MD. University of Hawaii – Department of Surgery

INTRODUCTION: Patients suffering from the burden of obesity are at significant risk for medical problems that lead to premature death and disability. We hypothesize that a multidisciplinary bariatric team will be better equipped to recognize and diagnose these conditions. This study hopes to quantify that a patient focused approach leads to increased recognition of obesity-associated comorbidities, thus improving quality of care and surgical outcomes.

METHODS AND PROCEDURE: A retrospective medical chart review of patients who underwent bariatric surgery from 12/1/15 to 12/1/16 was performed comparing patient problem lists obtained from their primary care providers upon entry into the bariatric program, and the final problem list generated after evaluation by the program’s multidisciplinary team. The total number and specific comorbidities identified before and after multidisciplinary team evaluation was analyzed with a paired t-test and MANOVA, respectively. Comparison of the number of comorbidities identified against specific patient demographics was conducted using paired t-test.

RESULTS: A total of 120 patient charts were selected and 100 met inclusion criteria. The sample consisted of 68% women and 32% men; the mean age was 46.5; the mean BMI was 51.2; 87% were morbidly obese (BMI ³ 40) and 13% were obese (BMI 30.0 – 39.9). The total number of comorbidities identified after evaluation by a multidisciplinary team was significantly greater (p=.000), with the average number of comorbidities diagnosed before and after being 3.65 and 6.61, respectively. A significant increase (p<0.05) in the identification of comorbidities before and after evaluation were noted for all demographics, and no disparities regarding gender, age, marital status, employment status, BMI, or ethnicity where identified.

CONCLUSION: Patients with obesity unknowingly suffer from many obesity-associated comorbidities simply because their health care providers have failed to recognize the existence of these conditions. Surprisingly, this include diseases that are highly associated with obesity, such as OSA and T2DM, for which obese patients should be screened. Although the root of this dereliction is yet to be determined, insufficient obesity-focused education and inherent weight bias among providers must be considered. Assessment by a multidisciplinary bariatric team resulted in the identification and treatment of an increased number of comorbidities in this patient population. Increased recognition of obesity-related comorbidities improves quality of care, which can translate into improved surgical outcomes.


Presented at the SAGES 2017 Annual Meeting in Houston, TX.

Abstract ID: 88586

Program Number: P755

Presentation Session: iPoster Session (Non CME)

Presentation Type: Poster

36

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