A new study published in Spine questions whether surgeons are overestimating the association between obesity and perioperative adverse outcomes due to ICD coding classifications.
Study authors gathered data on posterior lumbar fusion patients from 2013 to 2016 from procedures performed at a large academic hospital. There were 796 patients included in the study. Here are four key findings.
1. The overall ICD coding for obesity sensitivity was 42.5 percent and significantly higher in patients with the following factors:
• Greater BMI
• Diabetes
• American Society of Anesthesiologists Class III or above
• Longer length of stay
• Venous thromboembolism
• Adverse events
2. The study authors conducted a multivariate analysis to determine outcomes for increased risk with diabetes defined by the ICD coding, which included VTE, major adverse events and any adverse events.
3. Outcomes with increased risk didn't have positive associations with obesity when defined by BMI, according to the multivariate analysis.
4. Study authors concluded, "ICD codes for obesity are more commonly assigned to patients with other comorbidities or postoperative complications. Further, use of such nonrandomly assigned ICD codes for obesity has the potential to skew studies to suggest greater associated adverse events than calculated BMI would demonstrate."