Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA.
Department of Orthopaedics, Stony Brook University, Stony Brook, NY, USA.
J Shoulder Elbow Surg. 2021 Jul;30(7):1581-1587. doi: 10.1016/j.jse.2020.09.029. Epub 2020 Oct 22.
The purpose of this study was to investigate the association between increasing levels of obesity and postoperative complications within 30 days of arthroscopic rotator cuff repair (ARCR).
We queried the American College of Surgeons National Surgical Quality Improvement Program database for all patients who underwent ARCR from 2015 to 2017. Patients were stratified into 3 cohorts according to their body mass index (BMI). Patients with a BMI < 30 kg/m were placed in the non-obese cohort, patients with a BMI between 30 and 40 kg/m were placed in the obese cohort, and patients with a BMI > 40 kg/m were placed in the morbidly obese cohort. Postoperative complications within 30 days of the procedure were collected. Multivariate logistic regression was used to investigate the relationship between increasing levels of obesity and postoperative complications.
There were 18,521 patients included in this study. Of these patients, 9548 (51.6%) were non-obese, 7438 (40.2%) were obese, and 1535 (8.3%) were morbidly obese. A comparison among non-obese, obese, and morbidly obese patients showed increasing rates of medical complications (0.5% vs. 1.0% vs. 1.4%), pulmonary complications (0.1% vs. 0.3% vs. 0.5%), renal complications (0.0% vs. 0.1% vs. 0.2%), readmission (0.9% vs. 1.2% vs. 1.6%), nonhome discharge (0.4% vs. 0.5% vs. 1.2%), and overall complications (0.8% vs. 1.3% vs. 1.8%). In comparison to non-obesity, both obesity and morbid obesity were identified by multivariate analysis as significant predictors of medical complications (odds ratio [ORs] of 1.72 and 2.16, respectively), pulmonary complications (ORs of 2.66 and 4.06, respectively), and overall complications (ORs of 1.52 and 1.77, respectively).
This study used a large national database to identify increasing levels of obesity as a risk factor for medical complications, pulmonary complications, and overall complications within 30 days of ARCR.
本研究旨在探讨在关节镜肩袖修复术后 30 天内，肥胖程度的增加与术后并发症之间的关系。
我们在美国外科医师学院国家手术质量改进计划数据库中查询了 2015 年至 2017 年间接受关节镜肩袖修复术的所有患者。根据体重指数（BMI）将患者分为 3 组。BMI<30kg/m 的患者归入非肥胖组，BMI 在 30 至 40kg/m 之间的患者归入肥胖组，BMI>40kg/m 的患者归入病态肥胖组。收集术后 30 天内的术后并发症。采用多变量逻辑回归分析肥胖程度增加与术后并发症之间的关系。
本研究共纳入 18521 例患者。其中，9548 例（51.6%）为非肥胖患者，7438 例（40.2%）为肥胖患者，1535 例（8.3%）为病态肥胖患者。非肥胖、肥胖和病态肥胖患者之间的比较显示，医疗并发症的发生率逐渐增加（0.5%比 1.0%比 1.4%），肺部并发症（0.1%比 0.3%比 0.5%），肾脏并发症（0.0%比 0.1%比 0.2%），再入院率（0.9%比 1.2%比 1.6%），非家庭出院率（0.4%比 0.5%比 1.2%），总并发症发生率（0.8%比 1.3%比 1.8%）。多因素分析显示，与非肥胖相比，肥胖和病态肥胖均为医疗并发症（比值比[ORs]分别为 1.72 和 2.16）、肺部并发症（ORs 分别为 2.66 和 4.06）和总并发症（ORs 分别为 1.52 和 1.77）的显著预测因子。
本研究使用大型国家数据库确定肥胖程度的增加是关节镜肩袖修复术后 30 天内发生医疗并发症、肺部并发症和总并发症的危险因素。
