The impact of obesity on resource utilization among patients undergoing total joint arthroplasty
- 236 Downloads
The presence of obesity poses a challenge for clinical and administrative staff in the peri-operative setting. Evidence indicates that obesity may increase peri-operative complications. However, data on resource utilization in patients undergoing total knee and hip arthroplasty remain rare. Using national data, we sought to determine whether increasing levels of patient obesity is associated with greater resource utilization. We hypothesized that patient care in individuals with a body mass index (BMI) greater than 40 is associated with longer operative and anaesthetic times, longer hospital stays, and greater readmission rates.
We utilized national data from the National Surgical Quality Improvement Project and identified patients who underwent primary total knee arthroplasty (TKA) and total hip arthroplasty (THA). Patients were divided into three groups according to their BMI (18.5 BMI < 30, 40 BMI < 45, and 45 BMI). The groups were compared regarding associated operating room utilization, length of stay, and readmission rates.
Our study showed that TKA and THA patients with higher BMI required significantly longer operation-related times and had higher total length of hospital stay. Higher BMI patients also carried higher odds of readmissions within 30 days in both TKA and THA groups.
We conclude that BMI status needs to be considered for both medical and economic reasons by health care institutions and payers, in order to make prudent decisions in a world where health care expenses are rising rapidly alongside the increasing obesity epidemic, and resources are becoming increasingly scarce.
KeywordsObesity Body mass index Resource utilization Total knee arthroplasty Total hip arthroplasty
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
This article does not contain any studies with human participants or animals performed by any of the authors.
- 4.Kerkhoffs GM, Servien E, Dunn W, Dahm D, Bramer JA, Haverkamp D (2012) The influence of obesity on the complication rate and outcome of total knee arthroplasty: a meta-analysis and systematic literature review. J Bone Joint Surg Am 94(20):1839–1844. https://doi.org/10.2106/JBJS.K.00820 CrossRefGoogle Scholar
- 6.Malinzak RA, Ritter MA, Berend ME, Meding JB, Olberding EM, Davis KE (2009) Morbidly obese, diabetic, younger, and unilateral joint arthroplasty patients have elevated total joint arthroplasty infection rates. J Arthroplast 24(6 Suppl):84–88. https://doi.org/10.1016/j.arth.2009.05.016 CrossRefGoogle Scholar
- 13.Adhikary SD, Liu WM, Memtsoudis SG, Davis CM 3rd, Liu J (2016) Body mass index more than 45 kg/m(2) as a cutoff point is associated with dramatically increased postoperative complications in total knee arthroplasty and total hip arthroplasty. J Arthroplast 31(4):749–753. https://doi.org/10.1016/j.arth.2015.10.042 CrossRefGoogle Scholar