Impact of obesity on total hospital costs in patients who underwent colorectal cancer surgery

Abstract

Introduction: The prevalence of obesity is increasing at a rapid rate. Obesity is associated with greater use of healthcare resources and obese patients have higher costs compared with other standardized body mass groups. Obesity is well-known cause of many systemic diseases and related to the development of colorectal cancer. However, only few studies examined the impact of obesity in colorectal cancer patients. This study aimed to determine whether obesity increases hospital costs in patients who underwent colorectal cancer surgery.

Methods: We retrospectively collected hospital billings for patients who underwent surgery for stage I-III colorectal cancer and analyzed the association between obesity and hospital cost. Obesity was assessed by preoperative body mass index (BMI) and computed tomography-assessed adipose tissue area. Primary outcome was hospital costs assessed by direct hospital billing during hospitalization.

Results: A total of 656 patients were analyzed in the study. Mean BMI was 23.92 ± 2.912 kg/m2, mean total adipose tissue (TAT) area was 249.57 ± 92.82 cm2 and mean visceral adipose tissue (VAT) area was 101.50 ± 56.57 cm2. The mean cost during index admission was 6,442,162.52 ± 2,480,435.78 ￦. We defined obese as the value over the cutoff value. In multivariate analysis by each obesity indices, obese patients defined by TAT area was significantly associated with higher total medical cost (p=0.046) and in multivariate analysis for subdivided medical cost according to TAT area, the higher operation/consultation cost significantly associated with obesity (p=0.003).

Conclusions: Increased total adipose tissue area but not BMI was associated with higher medical costs (p=0.046) in colorectal cancer patients, especially associated with the higher operation/consultation cost (p=0.003).