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The Interaction of Obesity and Metabolic Syndrome in Determining Risk of Complication Following Total Joint Arthroplasty. J Arthroplasty 2016 09;31(9 Suppl):192-6

Date

07/17/2016

Pubmed ID

27421583

DOI

10.1016/j.arth.2016.05.016

Abstract

BACKGROUND: The arthroplasty population is increasingly comorbid, and current quality improvement initiatives demand accurate risk stratification. Metabolic syndrome (MetS) has been identified as a risk factor for adverse events after arthroplasty; however, its interaction with obesity in contributing to risk is unclear.

METHODS: A retrospective analysis of all Medicare patients undergoing total hip arthroplasty (THA) and total knee arthroplasty (TKA) at a single institution from 2009 to 2013 investigated the interaction between MetS, body mass index (BMI), and risk for Centers for Medicare and Medicaid Services (CMS)-reportable complications, readmission, and discharge disposition.

RESULTS: A total of 1462 patients (942 TKA, 538 THA) were included, of which 16.2% had MetS. Regression analysis found that MetS was significantly related to risk of CMS complications (odds ratio [OR] = 1.96, 95% confidence interval [CI] 1.16-3.31, P = .012) and nonhome discharge (OR = 1.78, 95% CI 1.39-2.27, P < .001), but not readmission (OR = 1.23, 95% CI 0.7-2.18, P = .485). Within the MetS cohort, increasing BMI was not associated with increasing complications (P = .726) or readmissions (P = .206) but was associated with nonhome discharge (OR = 1.191 per unit increase in BMI, 95% CI 1.038-1.246, P = .001).

CONCLUSION: MetS increases risk for CMS-reportable complications and nonhome discharge disposition after THA and TKA regardless of BMI. Obesity is of less value than MetS in assessing overall risk for complication after THA and TKA.

Author List

Edelstein AI, Suleiman LI, Alvarez AP, Sacotte RM, Qin CD, Beal MD, Manning DW

Author

Adam I. Edelstein MD Assistant Professor in the Orthopaedic Surgery department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Arthroplasty, Replacement, Hip
Arthroplasty, Replacement, Knee
Female
Humans
Male
Medicare
Metabolic Syndrome
Obesity
Odds Ratio
Patient Discharge
Postoperative Complications
Regression Analysis
Retrospective Studies
Risk Assessment
Risk Factors
United States
jenkins-FCD Prod-398 336d56a365602aa89dcc112f077233607d6a5abc