The Interaction of Obesity and Metabolic Syndrome in Determining Risk of Complication Following Total Joint Arthroplasty.
J Arthroplasty
; 31(9 Suppl): 192-6, 2016 09.
Article
em En
| MEDLINE
| ID: mdl-27421583
ABSTRACT
BACKGROUND:
The arthroplasty population is increasingly comorbid, and current quality improvement initiatives demand accurate risk stratification. Metabolic syndrome (MetS) has been identified as a risk factor for adverse events after arthroplasty; however, its interaction with obesity in contributing to risk is unclear.METHODS:
A retrospective analysis of all Medicare patients undergoing total hip arthroplasty (THA) and total knee arthroplasty (TKA) at a single institution from 2009 to 2013 investigated the interaction between MetS, body mass index (BMI), and risk for Centers for Medicare and Medicaid Services (CMS)-reportable complications, readmission, and discharge disposition.RESULTS:
A total of 1462 patients (942 TKA, 538 THA) were included, of which 16.2% had MetS. Regression analysis found that MetS was significantly related to risk of CMS complications (odds ratio [OR] = 1.96, 95% confidence interval [CI] 1.16-3.31, P = .012) and nonhome discharge (OR = 1.78, 95% CI 1.39-2.27, P < .001), but not readmission (OR = 1.23, 95% CI 0.7-2.18, P = .485). Within the MetS cohort, increasing BMI was not associated with increasing complications (P = .726) or readmissions (P = .206) but was associated with nonhome discharge (OR = 1.191 per unit increase in BMI, 95% CI 1.038-1.246, P = .001).CONCLUSION:
MetS increases risk for CMS-reportable complications and nonhome discharge disposition after THA and TKA regardless of BMI. Obesity is of less value than MetS in assessing overall risk for complication after THA and TKA.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Complicações Pós-Operatórias
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Artroplastia de Quadril
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Artroplastia do Joelho
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Síndrome Metabólica
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Obesidade
Idioma:
En
Ano de publicação:
2016
Tipo de documento:
Article