Obesity increases operating room times in patients undergoing primary hip arthroplasty: a retrospective cohort analysis.

Bassam Kadry,Alex Macario,Hassan Alosh,Christopher D Press,Igor A Popov,Jay B Brodsky,Isaac M Opper,Joe Orsini

doi:10.7717/peerj.530

Bassam Kadry, Alex Macario + Show 6 more

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https://doi.org/10.7717/peerj.530

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Abstract

Background. Obesity impacts utilization of healthcare resources. The goal of this study was to measure the relationship between increasing body mass index (BMI) in patients undergoing total hip arthroplasty (THA) with different components of operating room (OR) time.Methods. The Stanford Translational Research Integrated Database Environment (STRIDE) was utilized to identify all ASA PS 2 or 3 patients who underwent primary THA at Stanford Medical Center from February 1, 2008 through January 1, 2013. Patients were divided into five groups based on the BMI weight classification. Regression analysis was used to quantify relationships between BMI and the different components of total OR time.Results. 1,332 patients were included in the study. There were no statistically significant differences in age, gender, height, and ASA PS classification between the BMI groups. Normal-weight patients had a total OR time of 138.9 min compared 167.9 min (P < 0.001) for morbidly obese patients. At a BMI > 35 kg/m2 each incremental BMI unit increase was associated with greater incremental total OR time increases.Conclusion. Morbidly obese patients required significantly more total OR time than normal-weight patients undergoing a THA procedure. This increase in time is relevant when scheduling obese patients for surgery and has an important impact on health resource utilization.

Highlights

Using the World Health Organization’s (WHO) weight-class definitions, two-thirds of the adult population in the United States above the age of 60 years are “pre-obese” or “obese” (WHO, 2000; Flegal et al, 2010)
The goal of this study was to measure the relationship between increasing obesity in patients undergoing total hip arthroplasty (THA) with the various components of operating room (OR) time in order to determine how obesity contributes to overall case duration
We found that for patients undergoing THA, increasing body mass index (BMI) was associated with increased total OR time

Summary

Introduction

Using the World Health Organization’s (WHO) weight-class definitions, two-thirds of the adult population in the United States above the age of 60 years are “pre-obese” or “obese” (WHO, 2000; Flegal et al, 2010). There is evidence that the duration of certain surgical procedures and the total amount of time spent in the operating room (OR) are increased for obese patients (Batsis et al, 2009; Wang et al, 2013). The goal of this study was to measure the relationship between increasing body mass index (BMI) in patients undergoing total hip arthroplasty (THA) with different components of operating room (OR) time. Obese patients required significantly more total OR time than normal-weight patients undergoing a THA procedure This increase in time is relevant when scheduling obese patients for surgery and has an important impact on health resource utilization

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