Metabolic syndrome in the setting of obesity: impact on in-hospital complications and outcomes after total knee and hip arthroplasty.

IF 2.8 Q1 ORTHOPEDICS
Abdul K Zalikha, Muhammad A Waheed, Christeena Twal, Jacob Keeley, Mouhanad M El-Othmani, Inaya Hajj Hussein
{"title":"Metabolic syndrome in the setting of obesity: impact on in-hospital complications and outcomes after total knee and hip arthroplasty.","authors":"Abdul K Zalikha, Muhammad A Waheed, Christeena Twal, Jacob Keeley, Mouhanad M El-Othmani, Inaya Hajj Hussein","doi":"10.1302/2633-1462.510.BJO-2024-0055.R1","DOIUrl":null,"url":null,"abstract":"<p><strong>Aims: </strong>This study aims to evaluate the impact of metabolic syndrome in the setting of obesity on in-hospital outcomes and resource use after total joint replacement (TJR).</p><p><strong>Methods: </strong>A retrospective analysis was conducted using the National Inpatient Sample from 2006 to the third quarter of 2015. Discharges representing patients aged 40 years and older with obesity (BMI > 30 kg/m<sup>2</sup>) who underwent primary TJR were included. Patients were stratified into two groups with and without metabolic syndrome. The inverse probability of treatment weighting (IPTW) method was used to balance covariates.</p><p><strong>Results: </strong>The obese cohort with metabolic syndrome was significantly older, more likely to be female, had higher rates of Medicare insurance, and more likely to be non-Hispanic Black than the obese cohort without metabolic syndrome. In the unweighted analysis, patients with obesity and metabolic syndrome were more likely to experience cardiac, gastrointestinal, genitourinary, and postoperative anemia complications, had a longer length of stay, and were less likely to be discharged home compared to obese patients without metabolic syndrome. After adjusting for covariates using IPTW, patients with obesity and metabolic syndrome were more likely to experience postoperative anemia complications only and had lower rates of home discharge, but there were no significant differences in any other complication variables or length of stay.</p><p><strong>Conclusion: </strong>Given the variability of metabolic health in obesity, the development of tailored perioperative protocols and recommendations acknowledging this variability in metabolic health in obese patients would ultimately potentially benefit patients and improve outcomes of TJR.</p>","PeriodicalId":34103,"journal":{"name":"Bone & Joint Open","volume":"5 10","pages":"837-843"},"PeriodicalIF":2.8000,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11456367/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Bone & Joint Open","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1302/2633-1462.510.BJO-2024-0055.R1","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
引用次数: 0

Abstract

Aims: This study aims to evaluate the impact of metabolic syndrome in the setting of obesity on in-hospital outcomes and resource use after total joint replacement (TJR).

Methods: A retrospective analysis was conducted using the National Inpatient Sample from 2006 to the third quarter of 2015. Discharges representing patients aged 40 years and older with obesity (BMI > 30 kg/m2) who underwent primary TJR were included. Patients were stratified into two groups with and without metabolic syndrome. The inverse probability of treatment weighting (IPTW) method was used to balance covariates.

Results: The obese cohort with metabolic syndrome was significantly older, more likely to be female, had higher rates of Medicare insurance, and more likely to be non-Hispanic Black than the obese cohort without metabolic syndrome. In the unweighted analysis, patients with obesity and metabolic syndrome were more likely to experience cardiac, gastrointestinal, genitourinary, and postoperative anemia complications, had a longer length of stay, and were less likely to be discharged home compared to obese patients without metabolic syndrome. After adjusting for covariates using IPTW, patients with obesity and metabolic syndrome were more likely to experience postoperative anemia complications only and had lower rates of home discharge, but there were no significant differences in any other complication variables or length of stay.

Conclusion: Given the variability of metabolic health in obesity, the development of tailored perioperative protocols and recommendations acknowledging this variability in metabolic health in obese patients would ultimately potentially benefit patients and improve outcomes of TJR.

肥胖情况下的代谢综合征:对全膝关节和髋关节置换术后院内并发症和疗效的影响。
目的:本研究旨在评估肥胖情况下代谢综合征对全关节置换术(TJR)后院内预后和资源使用的影响:利用 2006 年至 2015 年第三季度的全国住院患者样本进行了回顾性分析。研究纳入了年龄在 40 岁及以上、患有肥胖症(体重指数大于 30 kg/m2)、接受初级全关节置换术的出院患者。患者被分为有代谢综合征和无代谢综合征两组。采用逆概率治疗加权(IPTW)法平衡协变量:结果:与无代谢综合征的肥胖人群相比,有代谢综合征的肥胖人群明显更年长、更可能是女性、有更高比例的医疗保险、更可能是非西班牙裔黑人。在非加权分析中,与无代谢综合征的肥胖患者相比,肥胖和代谢综合征患者更有可能出现心脏、胃肠道、泌尿生殖系统和术后贫血并发症,住院时间更长,出院回家的可能性更小。在使用IPTW对协变量进行调整后,肥胖和代谢综合征患者仅更有可能出现术后贫血并发症,出院回家的比例也更低,但在其他并发症变量或住院时间方面没有显著差异:结论:鉴于肥胖症患者代谢健康状况的多变性,制定有针对性的围手术期方案和建议,承认肥胖症患者代谢健康状况的这种多变性,最终将使患者受益,并改善 TJR 的治疗效果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
Bone & Joint Open
Bone & Joint Open ORTHOPEDICS-
CiteScore
5.10
自引率
0.00%
发文量
0
审稿时长
8 weeks
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信