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Title: Obesity Surgery Score (OSS) for Prioritization in the Bariatric Surgery Waiting List: a Need of Public Health Systems and a Literature Review
Authors: Casimiro Pérez, José Antonio
Fernández Quesada, Carlos
del Val Groba Marco, María
Arteaga González, Iván
Cruz Benavides, Francisco
Ponce, Jaime
de Pablos Velasco, Pedro 
Marchena Gómez, Joaquín 
UNESCO Clasification: 32 Ciencias médicas
321301 Cirugía abdominal
3212 Salud pública
Keywords: Obesity
Bariatric surgery
Issue Date: 2018
Publisher: 0960-8923
Journal: Obesity Surgery 
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.
ISSN: 0960-8923
DOI: 10.1007/s11695-017-3107-6
Source: Obesity Surgery [ISSN 0960-8923],v. 28, p. 1175-1184
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