From the Department of Foundational Medical Studies, Oakland University William Beaumont School of Medicine, Auburn Hills, MI (Dr. Hajj Hussein); the Department of Orthopaedic Surgery and Sports Medicine, Detroit Medical Center, Detroit, MI (Dr. El-Othmani and Dr. Zalikha); the Central Michigan University College of Medicine, Saginaw, MI (Crespi, and Tuluca); and the Oakland University William Beaumont School of Medicine, Auburn Hills, MI (Arapovic).
J Am Acad Orthop Surg Glob Res Rev. 2022 Aug 5;6(8). doi: 10.5435/JAAOSGlobal-D-22-00023. eCollection 2022 Aug 1.
There remain limited data on the effect of obesity on in-hospital outcomes after revision total hip arthroplasty (rTHA).
Discharge data from the National Inpatient Sample were used to identify patients undergoing rTHA from 2006 to 2015. Propensity score analysis was done to analyze the effects of obesity and morbid obesity on in-hospital economic and complication outcomes after rTHA.
The estimated 460,297 rTHAs were done during the study period. Obese patients were more likely to suffer from any complication than not obese patients (41.44% versus 39.41%, P = 0.0085), and morbidly obese patients were more likely to suffer from any complication than obese patients (47.22% versus 41.44%, P < 0.0001). Obesity was associated with increased risk of postoperative anemia compared with not obese patients, while morbid obesity was associated with increased risk of postoperative anemia, hematoma/seroma, wound dehiscence, and postoperative infection (P < 0.05). Morbidly obese patients also had a significantly greater average length of stay (6.40 days) than obese (5.23 days) and not obese (5.37 days) patients (P < 0.0001).
Although both obesity and morbid obesity are associated with higher risk of in-hospital postoperative complications after rTHA, morbid obesity is a larger risk factor and is associated with a longer length of stay.
关于肥胖对翻修全髋关节置换术（rTHA）后住院结果的影响，目前仍缺乏相关数据。
本研究使用国家住院患者样本中的出院数据，确定了 2006 年至 2015 年间接受 rTHA 的患者。采用倾向评分分析来分析肥胖和病态肥胖对 rTHA 后住院经济和并发症结果的影响。
研究期间共进行了约 460297 例 rTHA。肥胖患者发生任何并发症的可能性高于非肥胖患者（41.44%比 39.41%，P=0.0085），病态肥胖患者发生任何并发症的可能性高于肥胖患者（47.22%比 41.44%，P<0.0001）。与非肥胖患者相比，肥胖患者术后贫血的风险增加，而病态肥胖患者术后贫血、血肿/血清肿、伤口裂开和感染的风险增加（P<0.05）。病态肥胖患者的平均住院时间也明显长于肥胖患者（6.40 天）和非肥胖患者（5.37 天）（P<0.0001）。
尽管肥胖和病态肥胖均与 rTHA 后住院期间术后并发症的风险增加相关，但病态肥胖是一个更大的危险因素，并且与住院时间延长相关。
