Obesity is associated with poor surgical outcome and complications. The literature does not provide a comprehensive view on the effect of body mass index (BMI) on perioperative outcomes in orthopedic surgeries. Therefore, we aim to determine the effect of BMI on 30-day perioperative outcomes in patients undergoing the first 25 most commonly performed orthopedic surgeries using a retrospective cohort study design. The knowledge of the effect of BMI on orthopedic surgeries will improve the knowledge of surgeons about the expected morbidities.
Obesity is associated with poor surgical outcome and complications. The literature does not provide a comprehensive view on the effect of body mass index (BMI) on perioperative outcomes in orthopedic surgeries. Therefore, we aim to determine the procedure specific, independent-effect of BMI on 30-day perioperative outcomes in patients undergoing the first 25 most commonly performed orthopedic surgeries. The study is a retrospective cohort study. The subjects will be the individuals undergoing one of first 25 most commonly performed orthopedic surgeries, whose information is derived form the de-identified patients' data collected through the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database. The primary outcome will be composite post-operative morbidity. Specific morbidities will also be evaluated including cardiovascular, vascular and renal complications, length-of-stay (LOS), and the need for re-intervention and readmission, as well as 30-day mortality. Descriptive statistics and multivariable regression models will assess the independent-effect of BMI on outcomes. The knowledge of the effect of BMI on orthopedic surgeries will improve the knowledge of surgeons about the expected morbidities. The surgeon will be able to better counsel obese patients and devise a better surgical plan to prevent or deal with the expected outcomes.
Study Type
OBSERVATIONAL
Enrollment
76,189
One of the 25 most common orthopedic surgeries reported in the database which are the following as per surgical types: spine surgery (CPT codes 63030, 63047, 22612, 22551 or 22558), trauma (CPT codes 27236, 27125, 27244, 27814, or 27792), sports medicine injuries (CPT codes 29881, 29827, 29880, 29888, 29826, 29877, 29807, or 23412), or joint arthroplasty (CPT codes 27447, 27130, 23472, 27487, 27134, 27446, or 27486).
American University of Beirut Medical Center
Beirut, Lebanon
Composite morbidity
Composite morbidity is defined as the presence of any of the specific morbidities during the 30-days following surgery as recorded in the ACS-NSQIP database. The odds ratio of composite morbidity for each BMI group will be calculated as compared to normal-weight group.
Time frame: within the 30 days following the surgery
mortality
odds ratio of mortality within the 30-days following the surgery for each BMI group as compared to normal-weight group
Time frame: within the 30 days following the surgery
wound
odds ratio of specific morbidity of surgical wound for each BMI group as compared to normal-weight group
Time frame: within the 30 days following the surgery
cardiac
specific morbidity of cardiac complication for each BMI group as compared to normal-weight group
Time frame: within the 30 days following the surgery
respiratory
odds ratio of specific morbidity of respiratory complication
Time frame: within the 30 days following the surgery
urinary
odds ratio of specific morbidity of urinary complication for each BMI group as compared to normal-weight group
Time frame: within the 30 days following the surgery
neurological
odds ratio of specific morbidity of neurological (CNS) complication for each BMI group as compared to normal-weight group
Time frame: within the 30 days following the surgery
thromboembolism
odds ratio of specific morbidity of thromboembolism for each BMI group as compared to normal-weight group
Time frame: within the 30 days following the surgery
sepsis
odds ratio of specific morbidity of sepsis for each BMI group as compared to normal-weight group
Time frame: within the 30 days following the surgery
bleeding
odds ratio of bleeding or transfusion need for each BMI group as compared to normal-weight group
Time frame: within the 30 days following the surgery
Re-op
odds ratio of need for re-admission/re-operation for each BMI group as compared to normal-weight group
Time frame: within the 30 days following the surgery
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.