Carender Christopher N, Glass Natalie A, DeMik David E, Elkins Jacob M, Brown Timothy S, Bedard Nicholas A
Department of Orthopedics and Rehabilitation, University of Iowa Hospitals and Clinics, Iowa City, IA.
Department of Orthopedics and Sports Medicine, Houston Methodist Hospital, Houston, TX.
J Arthroplasty. 2022 May;37(5):874-879. doi: 10.1016/j.arth.2022.01.087. Epub 2022 Feb 4.
Obesity is associated with higher rates of adverse outcomes following primary total hip arthroplasty (THA). The purpose of this study is to utilize 3 national databases to develop projections of obesity within the general population and primary THA patients in the United States through 2029.
Data from the National Surgical Quality Improvement Program (NSQIP), the Behavior Risk Factor Surveillance System (BRFSS), and the National Health and Nutrition Examination Survey were queried for years 1999-2019. Current Procedural Terminology code 27130 was used to identify primary THA patients in NSQIP. Individuals were categorized according to body mass index (kg/m) by year: normal weight (≤24.9); overweight (25.0-29.9); obese (30.0-39.9); and morbidly obese (≥40). Multinomial logistic regression was used to project categorical body mass index data for years 2020-2029.
A total of 8,222,013 individuals were included (7,986,414 BRFSS, 235,599 NSQIP THA). From 2011 to 2019, the prevalence of normal weight and overweight individuals declined in the general population (BRFSS) and in primary THA. Prevalence of obese/morbidly obese individuals increased in the general population from 31% to 36% and in primary THA from 42% to 49%. Projection models estimate that by 2029, 46% of the general population will be obese/morbidly obese and 55% of primary THA will be obese/morbidly obese.
By 2029, we estimate ≥55% of primary THA to be obese/morbidly obese. Increased resources dedicated to care pathways and research focused on improving outcomes in obese arthroplasty patients will be necessary as this population continues to grow.
Level III, Retrospective Cohort Study.
肥胖与初次全髋关节置换术（THA）后更高的不良结局发生率相关。本研究的目的是利用3个国家数据库，对美国普通人群和初次THA患者到2029年的肥胖情况进行预测。
查询了1999 - 2019年国家外科质量改进计划（NSQIP）、行为危险因素监测系统（BRFSS）和国家健康与营养检查调查的数据。使用当前手术操作术语代码27130在NSQIP中识别初次THA患者。个体按年份根据体重指数（kg/m）分类：正常体重（≤24.9）；超重（25.0 - 29.9）；肥胖（30.0 - 39.9）；以及病态肥胖（≥40）。采用多项逻辑回归对2020 - 2029年的分类体重指数数据进行预测。
共纳入8,222,013名个体（7,986,414名BRFSS参与者，235,599名NSQIP的THA患者）。2011年至2019年，普通人群（BRFSS）和初次THA患者中正常体重和超重个体的患病率下降。普通人群中肥胖/病态肥胖个体的患病率从31%增至36%，初次THA患者中则从42%增至49%。预测模型估计，到2029年，46%的普通人群将为肥胖/病态肥胖，55%的初次THA患者将为肥胖/病态肥胖。
到2029年，我们估计≥55%的初次THA患者将为肥胖/病态肥胖。随着这一人群的持续增长，有必要增加用于护理途径的资源以及专注于改善肥胖关节置换患者结局的研究。
三级，回顾性队列研究。
