Obesity Surgery

, Volume 28, Issue 4, pp 1175–1184 | Cite as

Obesity Surgery Score (OSS) for Prioritization in the Bariatric Surgery Waiting List: a Need of Public Health Systems and a Literature Review

  • José Antonio Casimiro Pérez
  • Carlos Fernández Quesada
  • María del Val Groba Marco
  • Iván Arteaga González
  • Francisco Cruz Benavides
  • Jaime Ponce
  • Pedro de Pablos Velasco
  • Joaquín Marchena Gómez
New Concept



In the last decades, we have experienced an increase in the prevalence of obesity in western countries with a higher demand for bariatric surgery and consequently prolonged waiting times. Currently, in many public hospitals, the only criterion that establishes priority for bariatric surgery is waiting time regardless of obesity severity.


We propose a new, simple, and homogeneous clinical prioritization system, the Obesity Surgery Score (OSS), which takes into account simultaneously and equitably the time on surgical waiting list and the obesity severity based on three variables: body mass index, obesity-related comorbidities, and functional limitations. We have reviewed the current literature related to obesity clinical staging systems, and we have carried out an analysis of our patients in waiting list and divided their characteristics according to their degree of severity (A, B, or C) in the OSS. Patients with OSS grade C have a higher mean BMI, greater severity in comorbidities, and greater socio-labor impact. The current surgery waiting time of our series is of 26 months. Currently, 27 patients (51.9%) with OSS grade B and 15 patients (51.7%) with OSS grade C have been on our waiting list for more than 1 year.


Since the obesity severity, the waiting time and its clinical consequences are associated with an increase in morbidity and mortality, it is important to apply a structured prioritization system for bariatric surgery waiting list. This allows prioritization of patients at greater risk, improves patient prognosis, and optimizes costs and available health resources.


Morbid obesity Body mass index Bariatric surgery Obesity staging Risk factors Cardiovascular diseases Waiting list Waiting time Costs Public hospitals Hospital purchasing 


Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Informed Consent

It does not apply.

Human and Animal Rights

This article does not contain any studies with human participants or animals performed by any of the authors.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • José Antonio Casimiro Pérez
    • 1
  • Carlos Fernández Quesada
    • 1
  • María del Val Groba Marco
    • 2
  • Iván Arteaga González
    • 3
  • Francisco Cruz Benavides
    • 1
  • Jaime Ponce
    • 4
  • Pedro de Pablos Velasco
    • 5
  • Joaquín Marchena Gómez
    • 1
  1. 1.Servicio de Cirugía General y del Aparato DigestivoHospital Universitario de Gran Canaria Doctor NegrínLas Palmas de Gran Canaria, Las PalmasSpain
  2. 2.Servicio de CardiologíaHospital Universitario de Gran Canaria Doctor NegrínLas Palmas de Gran Canaria, Las PalmasSpain
  3. 3.Servicio de Cirugía General y del Aparato DigestivoHospital Universitario de CanariasSanta Cruz de TenerifeSpain
  4. 4.Chattanooga BariatricsChattanoogaUSA
  5. 5.Servicio de Endocrinología y NutriciónHospital Universitario de Gran Canaria Doctor NegrínLas Palmas de Gran Canaria, Las PalmasSpain

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