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

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Abstract

Background

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.

Methods

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.

Conclusion

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.

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Authors and Affiliations

  1. Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario de Gran Canaria Doctor Negrín, Las Palmas de Gran Canaria, Las Palmas, Spain

    José Antonio Casimiro Pérez, Carlos Fernández Quesada, Francisco Cruz Benavides & Joaquín Marchena Gómez

  2. Servicio de Cardiología, Hospital Universitario de Gran Canaria Doctor Negrín, Las Palmas de Gran Canaria, Las Palmas, Spain

    María del Val Groba Marco

  3. Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario de Canarias, La Laguna, Santa Cruz de Tenerife, Spain

    Iván Arteaga González

  4. Chattanooga Bariatrics, Chattanooga, TN, USA

    Jaime Ponce

  5. Servicio de Endocrinología y Nutrición, Hospital Universitario de Gran Canaria Doctor Negrín, Las Palmas de Gran Canaria, Las Palmas, Spain

    Pedro de Pablos Velasco

Authors
  1. José Antonio Casimiro Pérez
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  2. Carlos Fernández Quesada
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  8. Joaquín Marchena Gómez
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Correspondence to José Antonio Casimiro Pérez.

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Casimiro Pérez, J.A., Fernández Quesada, C., del Val Groba Marco, M. et al. Obesity Surgery Score (OSS) for Prioritization in the Bariatric Surgery Waiting List: a Need of Public Health Systems and a Literature Review. OBES SURG 28, 1175–1184 (2018). https://doi.org/10.1007/s11695-017-3107-6

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