Division of Adult Reconstruction Surgery, Department of Orthopaedic Surgery, New York University Hospital for Joint Diseases, New York, New York, USA.
J Arthroplasty. 2012 Mar;27(3):397-401. doi: 10.1016/j.arth.2011.04.017. Epub 2011 Jun 14.
The effect of obesity on the outcomes of total joint arthroplasties is an ongoing concern. As obesity becomes more endemic, new categories emerge, such as the "super-obese." We conducted a retrospective study to determine the difference in outcomes among the super-obese. When categorized according to body mass index (BMI), the overall rate of complications was higher for patients with BMI of 45 or higher. Super-obese patients had an odds ratio (OR) of 8.44 for developing inhospital complications. Most importantly, each incremental 5-U increase in BMI above 45 was associated with an increased risk of inhospital (OR, 1.69) and outpatient complications (OR, 2.71), and readmission (OR, 2.0), compared with patients with BMI of 45 to 50. Length of stay was increased by 13.8% for each 5-U increase in BMI above 45. There is a significant increased risk for complications in the super-obese population, and this continues to increase with BMI increases above 45. These data are important when counseling super-obese patients and should be accounted for in reporting quality outcome measures in this population.
肥胖对全关节置换术结果的影响一直是人们关注的问题。随着肥胖的日益普遍，新的类别出现了，比如“超级肥胖”。我们进行了一项回顾性研究，以确定超级肥胖患者之间的结果差异。根据体重指数 (BMI) 进行分类时，BMI 为 45 或更高的患者并发症发生率更高。超级肥胖患者发生院内并发症的优势比 (OR) 为 8.44。最重要的是，与 BMI 为 45 至 50 的患者相比，BMI 每增加 5 个单位以上至 45 以上，与院内 (OR, 1.69) 和门诊并发症 (OR, 2.71) 以及再入院 (OR, 2.0) 的风险增加相关，BMI 每增加 5 个单位以上，住院时间延长 13.8%。超级肥胖人群的并发症风险显著增加，并且随着 BMI 增加超过 45，这种风险持续增加。在为超级肥胖患者提供咨询时，这些数据非常重要，并且应该在报告该人群的质量结果测量指标时加以考虑。
