Oral Presentation ANZOS-OSSANZ-AOCO Joint Annual Scientific Meeting 2017

The Overlooked: Obesity is often undiagnosed in hospitalised patients and is associated with significantly greater health costs and comorbidities (#154)

Ramy H Bishay 1 2 3 , Gideon Meyerowitz-Katz 1 , Tien-Ming Hng 1 2 , Rajini Jayaballa 1 , Michael Edye 4 , Glen F Maberly 1 2 3
  1. Western Sydney Diabetes, Integrated and Community Health Directorate, Blacktown Hospital Department of Endocrinology and Diabetes, Western Sydney Local Health District, Sydney, NSW, Australia
  2. School of Medicine, University of Western Sydney, Sydney, NSW, Australia
  3. School of Medicine, University of Sydney, Sydney, NSW, Australia
  4. Department of Surgery, Blacktown Hospital, Blacktown, NSW, Australia

Introduction:

The World Obesity Foundation has recently joined a growing list of organisations declaring obesity as a disease. In spite of this, obesity and its severity are scarcely objectively documented in hospitalised patients. We sought to determine the performance in diagnosing obesity at our hospital, a major tertiary centre in Western Sydney, where obesity and overweight individuals constitute 50% of the population.

Method:

An intake database as part of the Diabetes Detection and Management Strategy collected data of all patients who were admitted to Blacktown and Mt Druitt hospitals during April 2016 to February 2017. Basic demographic and diagnostic coding (specifically for obesity and related conditions) were analysed to determine the prevalence, rate of diagnosis of obesity and its impact on health costs.

Results:

Of a total of 43,212 admissions, a mere 390 had an obesity diagnosis (0.90% of the cohort); the latter were mostly English-speaking (92%), slightly older (57 vs 51 yrs), had significantly greater number of comorbidities (median 14 vs 4, p<0.001) and a higher prevalence of type 2 diabetes (62 vs 20%, p <0.001). Compared with non-diagnosed obese inpatients, patients with an obesity diagnosis had a significantly higher length of stay in hospital (median 190 vs 25 days, p<0.001) and intensive care (1.86 + 5.68 vs 0.23 + 1.71 days, p<0.001), as well as health expenditure (national weighted activity unit, a measure of health service activity expressed as a unit; 2.04 vs 0.83 p<0.001). Information on the severity of obesity and the prevalence of obesity-related comorbidities is ongoing.

Conclusion:

Acknowledgement of obesity by clinical staff clearly needs attention, especially in a population where obesity is nearly endemic. Targeted resource allocation should promote identification and initiation of treatment in patients identified as obese, considering the higher economic burden and comorbidities attributed to this disease.