Two important patient safety trends have emerged in a Michigan bariatric registry: An intervention to prevent blood clots, a possibly deadly complication, did more harm than good. And a new option that removes most of the stomach -- called sleeve gastrectomy -- is proving to be safe, effective and growing in popularity, though most insurers don't cover it.
The information comes from the Michigan Bariatric Surgery Collaborative, one of the largest databases of its kind in the country.
Already the findings have changed how bariatric weight-loss surgery is performed in the state and saved enough money to more than pay for the $1.5 million a year that Blue Cross Blue Shield of Michigan provides to fund the registry.
The database is an example of how savings can be achieved in health care through quality measurements like registries.
These findings show that sleeve gastrectomy is fast becoming a procedure of choice, over Lap-Band surgery, and that insertion of a tiny cage or filter in the leg to prevent blood clots -- a rare but possibly deadly complication -- contributed to more problems in patients than those who did not get the intervention.
What the registry revealed
It took two bariatric surgeries for Kim Bodnar to achieve the weight loss she wanted.
At 297 pounds, she underwent Lap-Band surgery, a bariatric procedure that tightens the stomach with a device that limits food intake.
She lost 30 pounds in the first year after the 2005 operation.
Dissatisfied with the amount she lost, she underwent another procedure in January 2008 called sleeve gastrectomy, which removes 85% of the stomach and creates a banana- or sleeve-like organ that limits food intake and curbs appetite. It's so new that many Michigan bariatric surgeons didn't do it a year ago.
Now Bodnar weighs 148 pounds, has rejoined her husband on his motorcycle and is happy with herself physically and mentally, she said. "It's the best thing I've ever done for myself," said Bodnar, 38, of New Haven.
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