Abstract
BackgroundWhile obesity has been clearly established as a risk factor for osteoarthritis (OA), there is a scarcity of studies comparing outcomes between obese and non-obese patients with hip OA who underwent hip arthroplasty.MethodsThis study involved adults with hip OA who had hip replacement procedures. Data was sourced from the Nationwide Inpatient Sample (NIS) database for 2016 and 2017. The primary outcome was inpatient mortality. Secondary outcomes included the development of non-ST segment elevation myocardial infarction (NSTEMI), sepsis, post-procedure site infection, pneumonia, acute kidney failure, deep vein thrombosis (DVT), pulmonary embolism, need for transfusion of blood products, complications involving orthopedic devices as well as mean length of hospitalization and mean total hospital charges.ResultsObese patients did not have higher odds of in-hospital mortality (adjusted odds ratio [aOR]: 0.65, 95% CI 0.303-1.381, p=0.260), had increased mean length of hospitalization (0.11, 95% CI 0.083-0.134, p<0.001) and higher odds of developing DVT (aOR: 1.62, 95% CI 1.187-2.222, p<0.001), acute kidney failure (aOR: 1.64, 95% CI: 1.488-1.807, p<0.001) and pressure-related injuries (aOR: 1.64, 95% CI 1.081-2.483, p=0.020), compared with non-obese patients. Obese patients were found to have a lower aOR of having NSTEMI (aOR: 0.57, 95% CI 0.332-0.986, p=0.044), and need for blood product transfusion (aOR: 0.80, 95% CI 0.726-0.875, p<0.001).ConclusionAlthough there is no difference in mortality among obese and non-obese patients who had hip arthroplasty, obese adults have increased odds of morbidity and perioperative complications. Hence, obese adults likely require better perioperative management to decrease the incidence of these complications.
Highlights
The World Health Organization defines obesity as abnormal or excessive fat accumulation that presents a risk to health
Obese patients did not have higher odds of in-hospital mortality, had increased mean length of hospitalization (0.11, 95% CI 0.083-0.134, p
Obese patients were found to have a lower aOR of having non-ST segment elevation myocardial infarction (NSTEMI), and need for blood product transfusion
Summary
The World Health Organization defines obesity as abnormal or excessive fat accumulation that presents a risk to health. Obesity is one of the most well-defined risk factors for osteoarthritis (OA). OA is the most common degenerative disease of the joints, leading to substantial pain and disability world over [2]. Hip OA causes severe pain and stiffness of the hip joints leading to significant disability that often requires surgical intervention. According to the Global Burden of Disease 2010 study, the global agestandardized prevalence of hip OA was 0.85% (95% uncertainty interval 0.74%-1.02%) [7]. While obesity has been clearly established as a risk factor for osteoarthritis (OA), there is a scarcity of studies comparing outcomes between obese and non-obese patients with hip OA who underwent hip arthroplasty
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