The Effect of BMI on 30 Day Outcomes Following Total Joint Arthroplasty

Hasham M Alvi; Rachel E Mednick; Varun Krishnan; Mary J Kwasny; Matthew D Beal; David W Manning

doi:10.1016/j.arth.2015.01.049

The Effect of BMI on 30 Day Outcomes Following Total Joint Arthroplasty

J Arthroplasty. 2015 Jul;30(7):1113-7. doi: 10.1016/j.arth.2015.01.049. Epub 2015 Feb 7.

Authors

Hasham M Alvi¹, Rachel E Mednick¹, Varun Krishnan¹, Mary J Kwasny², Matthew D Beal¹, David W Manning¹

Affiliations

¹ Department of Orthopaedic Surgery, Northwestern University, Chicago, Illinois.
² Biostatistics Collaboration Center, Department of Preventive Medicine, Northwestern University, Chicago, Illinois.

PMID: 25683294
DOI: 10.1016/j.arth.2015.01.049

Abstract

Hip and knee arthroplasty (THA, TKA) are safe, effective procedures with reliable, reproducible outcomes. We aim to investigate obesity's effect on complications following arthroplasty surgery. Using the American College of Surgeons-National Surgical Quality Improvement Program database, 13,250 subjects were stratified into 5 groups based on BMI and matched for gender, age, surgery type and ASA class. Matched, multivariable generalized linear models adjusting for demographics and comorbidities demonstrated an association between elevated BMI and overall (P<0.001), medical (P=0.005), surgical complications (P<0.001), including superficial (P=0.019) and deep wound infection (P=0.040), return to OR (P=0.016) and time from OR to discharge (P=0.003). Elevated BMI increases risk for post-operative complications following total joint arthroplasty.

Keywords: BMI; arthroplasty; complications; readmission; risk stratification.

MeSH terms

Aged
Arthroplasty, Replacement, Hip / adverse effects*
Arthroplasty, Replacement, Knee / adverse effects*
Body Mass Index*
Comorbidity
Female
Humans
Joint Diseases / surgery
Male
Middle Aged
Obesity / complications*
Patient Readmission
Postoperative Complications / epidemiology*
Risk Factors
Treatment Outcome