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Quality-adjusted life expectancy benefits of laparoscopic bariatric surgery: A United States perspective

Published online by Cambridge University Press:  29 June 2010

Lyndon V. Hernandez  and
Dominic Klyve
Lyndon V. Hernandez
Affiliation:
Harvard School of Public Health and Aurora Medical Center–Kenosha
Dominic Klyve
Affiliation:
Carthage College
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Abstract

Objectives: The method of choice for bariatric surgery remains controversial. The aim of this study was to compare the outcome of laparoscopic Roux-en-Y gastric bypass (L-RYGB) versus laparoscopic adjustable gastric banding (LAGB) using quality-adjusted life-years (QALYs).

Methods: We developed a Markov model of the quality of life and survival of L-RYGB and LAGB in obese patients. Using census data, we estimated the probability of dying and quality of life for each year of each cohort.

Results: For all cohorts, L-RYGB offers the highest advantage in QALYs compared with gastric banding. The youngest cohort showed the greatest discrepancy between the two surgical methods, with 7.8, 6.4, and 4.7 QALYs gained with L-RYGB over LAGB for the age groups 35, 45, and 55, respectively. Those with the highest presurgical body mass index (BMI) acquired the most advantage with L-RYGB, with 2.8, 6.4, and 9.6 QALYs gained with L-RYGB over LAGB for the BMI groups 40, 50, and 60. Males had a slightly higher advantage with L-RYGB, with 6.5 QALYs gained with L-RYGB over LAGB compared with 6.0 QALYs for females.

Conclusions: For the cohorts studied, L-RYGB is the preferred surgical treatment for obesity if the sole metric is QALYs. The young and extremely obese are core groups who will gain the most QALYs following L-RYGB.

Keywords

laparoscopic Roux-en-Y gastric bypass (L-RYGB)laparoscopic adjustable gastric banding (LAGB)Quality-adjusted life-years (QALYs)Markov modelObesity
Type
ASSESSMENTS
Information
International Journal of Technology Assessment in Health Care , Volume 26 , Issue 3 , July 2010 , pp. 280 - 287
Copyright
Copyright © Cambridge University Press 2010

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