School of Medicine and Health, Durham University, Queen's Campus, Stockton-on-Tees, UK; The National Joint Registry for England and Wales; School of Medicine, Pharmacy and Health, Durham University, Queen's Campus, Stockton-on-Tees, UK.
School of Medicine and Health, Durham University, Queen's Campus, Stockton-on-Tees, UK; School of Medicine, Pharmacy and Health, Durham University, Queen's Campus, Stockton-on-Tees, UK.
J Arthroplasty. 2014 Oct;29(10):1889-98. doi: 10.1016/j.arth.2014.05.019. Epub 2014 Jun 2.
Influence of BMI upon patient outcomes and complications following THA was examined across a national cohort of patients. Outcomes were compared by BMI groups (19.0-29.9kg/m(2) [reference], 30.0-34.9kg/m(2) [obese class I], 35.0kg/m(2)+ [obese class II/III]), adjusted for case-mix differences. Obese class I patients had a significantly smaller improvement in OHS (18.9 versus 20.5, P<0.001) and a greater risk of wound complications (odds ratio [OR]=1.57, P=0.006). For obese class II/III patients, there were significantly smaller improvements in OHS and EQ-5D index (P<0.001), and greater risk of wound complications (P=0.006), readmission (P=0.001) and reoperation (P=0.003). Large improvements in patient outcomes were seen irrespective of BMI, although improvements were marginally smaller and complication rates higher in obese patients.
本研究旨在调查 BMI 对全髋关节置换术（THA）患者结局和并发症的影响，研究对象为全国范围内的患者队列。通过 BMI 分组（19.0-29.9kg/m²[参考组]、30.0-34.9kg/m²[肥胖 I 级]、35.0kg/m²+[肥胖 II/III 级]）比较患者结局，对病例组合差异进行校正。肥胖 I 级患者的 OHS 改善明显较小（18.9 分比 20.5 分，P<0.001），且伤口并发症风险更高（比值比 [OR]=1.57，P=0.006）。肥胖 II/III 级患者的 OHS 和 EQ-5D 指数改善明显较小（P<0.001），伤口并发症（P=0.006）、再入院（P=0.001）和再次手术（P=0.003）风险更高。无论 BMI 如何，患者结局均有较大改善，但肥胖患者的改善幅度较小，并发症发生率较高。
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