Gonuguntla Rishi, Ghali Abdullah, Prabhakar Gautham, Momtaz David, Ahmad Farhan, Slocum Dean, Kotzur Travis, Cushing Tucker, Saydawi Adnan, Wu Chia
From the UT Health San Antonio, Department of Orthopaedics, San Antonio, Tex.
Baylor College of Medicine, Department of Orthopaedics, Houston, Tex.
Plast Reconstr Surg Glob Open. 2023 Jun 9;11(6):e5049. doi: 10.1097/GOX.0000000000005049. eCollection 2023 Jun.
The rate and severity of obesity has risen over the past 40 years, and class III (formerly morbid) obesity presents additional sequelae. The effect of obesity on the incidence and recovery of hand and wrist fractures remains unclear. We sought to quantify the relationship between class III obesity and postoperative distal radius fracture (DRF) complications.
We performed a retrospective analysis of the American College of Surgeons-National Surgical Quality Improvement Program (ACS-NSQIP) database for surgical DRF patients more than 50 years old from 2015 to 2020. We then stratified patients into class III obese (BMI > 40) and compared the rates of postoperative complications to a control group with BMI less than 40.
We included 10,022 patients (570 class III obese vs. 9,452 not class III obese). Patients with class III obesity had significantly increased odds of experiencing any complication (OR 1.906, <0.001), adverse discharge (OR 2.618, <0.001), delayed hospital stay of longer than three days (OR 1.91, <0.001), and longer than seven days (OR 2.943, <0.001) than controls. They also had increased odds of unplanned reoperation (OR 2.138, = 0.026) and readmission (OR 2.814, < 0.001) than non-class III obese patients. Class III obese patients had a significantly longer average operation time (79.5 min vs. 72.2 min, < 0.001). They also spent more time in the hospital postoperatively (0.86 days vs. 0.57 days, = 0.001).
Class III obese patients undergoing DRF repair are more likely to experience postoperative complications than non-class III obese patients.
在过去40年里，肥胖的发生率和严重程度都有所上升，III级（原称病态）肥胖还会带来其他一系列后果。肥胖对手腕骨折的发生率和恢复的影响尚不清楚。我们试图量化III级肥胖与桡骨远端骨折（DRF）术后并发症之间的关系。
我们对美国外科医师学会-国家外科质量改进计划（ACS-NSQIP）数据库进行了回顾性分析，研究对象为2015年至2020年期间年龄超过50岁的接受手术治疗的DRF患者。然后，我们将患者分为III级肥胖组（BMI>40），并将术后并发症发生率与BMI小于40的对照组进行比较。
我们纳入了10022例患者（570例III级肥胖患者与9452例非III级肥胖患者）。III级肥胖患者发生任何并发症（比值比1.906，<0.001）、不良出院（比值比2.618，<0.001）、住院延迟超过三天（比值比1.91，<0.001）和超过七天（比值比2.943，<0.001）的几率均显著高于对照组。与非III级肥胖患者相比，他们计划外再次手术（比值比2.138，=0.026）和再次入院（比值比2.814，<0.001）的几率也更高。III级肥胖患者的平均手术时间明显更长（79.5分钟对72.2分钟，<0.001）。他们术后在医院的停留时间也更长（0.86天对0.57天，=0.001）。
接受DRF修复手术的III级肥胖患者比非III级肥胖患者更易发生术后并发症。
