An increased body mass index was not associated with higher rates of 30-day postoperative complications after unicompartmental knee arthroplasty.


Journal

The Knee
ISSN: 1873-5800
Titre abrégé: Knee
Pays: Netherlands
ID NLM: 9430798

Informations de publication

Date de publication:
Jun 2019
Historique:
received: 30 11 2018
revised: 04 02 2019
accepted: 17 02 2019
pubmed: 25 3 2019
medline: 24 10 2019
entrez: 24 3 2019
Statut: ppublish

Résumé

The association of postoperative complications and obesity after total knee arthroplasty (TKA) has been well described. However, the effect of an increased body-mass index (BMI) on postoperative complications after unicompartmental knee arthroplasty (UKA) is controversial. Therefore, our aim was to assess the influence of BMI on 30-day postoperative complications after UKA when analyzed as both a categorical and continuous variable. The American College of Surgeons National Quality Improvement Program (NSQIP) database was used to identify a total of 8029 patients who underwent UKA from January 1, 2008, to December 31, 2016. The database was queried for over 30 unique complications occurring within 30 days. The impact of BMI on short-term outcomes was assessed as a categorical variable using univariate and multivariate regression. Additionally, BMI was assessed as a continuous variable using spline regressions. Univariate regression analysis revealed that compared to normal weight patients, overweight patients had a lower risk of major complication (odds ratio [OR], 0.506; 95% confidence interval [CI], 0.279-0.918; p = 0.025), and any complication ([OR] 0.632; 95% CI, 0.423-0.944; p = 0.025) Multivariate regression analysis found no statistically significant relationship between categorical BMI and complications or outcomes, except for morbidly obese patients who had a greater risk of superficial SSI (p = 0.026). Spline regression found no statistically significant non-linear relationships between BMI and any complication (p = 0.4687), major complications (p = 0.1567), or minor complications (p = 0.4071). Overweight and obese individuals who undergo UKA may not have an increased risk of 30-day postoperative complications compared to normal weight individuals.

Sections du résumé

BACKGROUND BACKGROUND
The association of postoperative complications and obesity after total knee arthroplasty (TKA) has been well described. However, the effect of an increased body-mass index (BMI) on postoperative complications after unicompartmental knee arthroplasty (UKA) is controversial. Therefore, our aim was to assess the influence of BMI on 30-day postoperative complications after UKA when analyzed as both a categorical and continuous variable.
METHODS METHODS
The American College of Surgeons National Quality Improvement Program (NSQIP) database was used to identify a total of 8029 patients who underwent UKA from January 1, 2008, to December 31, 2016. The database was queried for over 30 unique complications occurring within 30 days. The impact of BMI on short-term outcomes was assessed as a categorical variable using univariate and multivariate regression. Additionally, BMI was assessed as a continuous variable using spline regressions.
RESULTS RESULTS
Univariate regression analysis revealed that compared to normal weight patients, overweight patients had a lower risk of major complication (odds ratio [OR], 0.506; 95% confidence interval [CI], 0.279-0.918; p = 0.025), and any complication ([OR] 0.632; 95% CI, 0.423-0.944; p = 0.025) Multivariate regression analysis found no statistically significant relationship between categorical BMI and complications or outcomes, except for morbidly obese patients who had a greater risk of superficial SSI (p = 0.026). Spline regression found no statistically significant non-linear relationships between BMI and any complication (p = 0.4687), major complications (p = 0.1567), or minor complications (p = 0.4071).
CONCLUSION CONCLUSIONS
Overweight and obese individuals who undergo UKA may not have an increased risk of 30-day postoperative complications compared to normal weight individuals.

Identifiants

pubmed: 30902511
pii: S0968-0160(19)30043-2
doi: 10.1016/j.knee.2019.02.009
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

720-728

Informations de copyright

Copyright © 2019 Elsevier B.V. All rights reserved.

Auteurs

Kavin Sundaram (K)

Department of Orthopaedic Surgery, Cleveland Clinic, 9500 Euclid Ave/A41, Cleveland, OH 44195, United States of America. Electronic address: sundark2@ccf.org.

Jared Warren (J)

Department of Orthopaedic Surgery, Cleveland Clinic, 9500 Euclid Ave/A41, Cleveland, OH 44195, United States of America. Electronic address: warrenj4@ccf.org.

Hiba Anis (H)

Department of Orthopaedic Surgery, Cleveland Clinic, 9500 Euclid Ave/A41, Cleveland, OH 44195, United States of America. Electronic address: anish@ccf.org.

Jaiben George (J)

All-Indian Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India.

Trevor Murray (T)

Department of Orthopaedic Surgery, Cleveland Clinic, 9500 Euclid Ave/A41, Cleveland, OH 44195, United States of America. Electronic address: murrayt2@ccf.org.

Carlos A Higuera (CA)

Department of Orthopaedic Surgery, Cleveland Clinic, 9500 Euclid Ave/A41, Cleveland, OH 44195, United States of America. Electronic address: higuerac@ccf.org.

Nicolas S Piuzzi (NS)

Department of Orthopaedic Surgery, Cleveland Clinic, 9500 Euclid Ave/A41, Cleveland, OH 44195, United States of America; Instituto Universitario del Hospital Italiano de Buenos Aires, Buenos Aires, Argentina. Electronic address: piuzzin@ccf.org.

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