The University of Melbourne and St. Vincent's Hospital Melbourne, Melbourne, Victoria, Australia.
Arthritis Care Res (Hoboken). 2011 Oct;63(10):1375-81. doi: 10.1002/acr.20563.
To compare the hospital inpatient costs between nonobese and obese patients and estimate the economic burden of obesity in primary total knee arthroplasty (TKA).
A cost identification study was conducted in a consecutive cohort of 530 patients who underwent TKA between 2006 and 2007 at a university-affiliated tertiary referral center in Melbourne, Australia. Total hospital inpatient costs incurred at the study institution associated with the index surgery and subsequent related emergency presentations and readmissions during the episode of care were captured. Predictor variables of interest were obesity and body mass index (BMI), and the outcomes of interest were total hospital inpatient costs for the index surgery and episode of care, defined as the first 12 months following TKA. Multivariate linear regression techniques were used to examine the association between the predictors of interest and hospital costs, adjusting for clinically relevant variables.
Economic data were analyzed in 521 patients, of which 317 (60.8%) were obese. Obesity was associated with higher inpatient index surgery costs (+$1,226.89 [95% confidence interval (95% CI) $82.25, $2,371.52]; P = 0.036) and episode of care costs (+$1,821.36 [95% CI $244.93, $3,397.79]; P = 0.024). Each unit increase in BMI was also associated with higher inpatient index surgery costs ($128.91 [95% CI $34.53, $223.28]; P = 0.008) and total episode of care costs ($158.79 [95% CI $28.54, $289.05]; P = 0.017).
The estimated significant additional annual obesity-related expenditure reported in this study establishes a rationale to trial and evaluate interventions that target weight loss in obese patients undergoing TKA from both a quality of life and economic perspective.
比较非肥胖患者和肥胖患者的住院患者费用，并估算原发性全膝关节置换术（TKA）中肥胖的经济负担。
在澳大利亚墨尔本的一所大学附属医院，对 2006 年至 2007 年间接受 TKA 的 530 例连续患者进行了一项成本识别研究。记录了与该手术相关的研究机构的总住院患者费用以及治疗期间发生的紧急就诊和再次入院的相关费用。感兴趣的预测变量是肥胖和体重指数（BMI），感兴趣的结果是手术和治疗期间的总住院患者费用，定义为 TKA 后 12 个月内。使用多元线性回归技术来检查感兴趣的预测变量与住院费用之间的关联，同时调整了临床相关变量。
对 521 例患者进行了经济数据分析，其中 317 例（60.8%）为肥胖患者。肥胖与更高的住院手术费用（+1226.89 美元[95%置信区间（95%CI）为 82.25 美元，2371.52 美元]；P=0.036）和治疗期间的费用（+1821.36 美元[95%CI 为 244.93 美元，3397.79 美元]；P=0.024）相关。体重指数每增加一个单位也与更高的住院手术费用（+128.91 美元[95%CI 为 34.53 美元，223.28 美元]；P=0.008）和治疗总费用（+158.79 美元[95%CI 为 28.54 美元，289.05 美元]；P=0.017）相关。
本研究报告了肥胖相关的额外年度支出的估计，这为从生活质量和经济角度评估和试验针对肥胖患者 TKA 的减肥干预措施提供了依据。
