Health Policy and EconomicsThe Impact of Metabolic Syndrome on 30-Day Complications Following Total Joint Arthroplasty
Section snippets
Data Acquisition and Definitions
Data were acquired from the American College of Surgeon's National Surgery Quality Improvement Program (ACS-NSQIP). In brief, the program consists of over 450 surgery centers, ranging from small community practices to urban academic hospitals. Data are collected through clinical nurse reviewers; these are highly trained, independent reporters designated and employed by NSQIP itself. The program provides reliable data that have been validated multiple times and used extensively in orthopedic
Results
After application of exclusion criteria, 107,117 patients were available for the study. Criteria for MetS were met by 10.3% (11,030) patients. MetS was associated with increased risk of CMS complications (odds ratio [OR] = 1.415; 95% confidence interval [CI], 1.306-1.533; P < .001), wound complications (OR = 1.749; 95% CI, 1.482-2.064; P < .001), and readmission (OR = 1.451; 95% CI, 1.314-1.602; P < .001).
Of those with MetS, 4174 (37.8%) had a BMI of 30-35; 3462 (31.4%) had a BMI 35-40; and
Discussion
The rising rate of obesity and its link to increased risk of developing osteoarthritis have contributed to a dramatic increase in the rate of obesity among those seeking joint replacement surgery 23, 24, 25. The association of obesity with higher risk of complication following arthroplasty has led to various risk mitigation efforts, even including bariatric surgery, but with mixed results 6, 26, 27. Along with the increased prevalence of obesity, there has been a corresponding rise in the
References (34)
- et al.
Surgeon compensation: “pay for performance,” the American College of Surgeons National Surgical Quality Improvement Program, the Surgical Care Improvement Program, and other considerations
Surgery
(2005) - et al.
Bariatric surgery prior to total knee arthroplasty is associated with fewer postoperative complications
J Arthroplasty
(2015) - et al.
The effect of obesity and increasing age on operative time and length of stay in primary hip and knee arthroplasty
J Arthroplasty
(2014) - et al.
The impact of body mass index on patient reported outcome measures (PROMs) and complications following primary hip arthroplasty
J Arthroplasty
(2014) - et al.
The effect of body mass index on outcome in total hip arthroplasty: early analysis from the New Zealand Joint Registry
J Arthroplasty
(2014) - et al.
The effect of BMI on 30 day outcomes following total joint arthroplasty
J Arthroplasty
(2015) - et al.
Impact of metabolic syndrome on perioperative complication rates after total joint arthroplasty surgery
J Arthroplasty
(2014) - et al.
Design and statistical methodology of the National Surgical Quality Improvement Program: why is it what it is?
Am J Surg
(2009) - et al.
Toward robust information: data quality and inter-rater reliability in the American College of Surgeons National Surgical Quality Improvement Program
J Am Coll Surg
(2010) - et al.
Effect of metabolic syndrome on perioperative outcomes after liver surgery: a National Surgical Quality Improvement Program (NSQIP) analysis
Surgery
(2012)
A simulation study of the number of events per variable in logistic regression analysis
J Clin Epidemiol
Bariatric surgery prior to total joint arthroplasty may not provide dramatic improvements in post-arthroplasty surgical outcomes
J Arthroplasty
Total knee arthroplasty in morbidly obese patients treated with bariatric surgery: a comparative study
J Arthroplasty
The metabolic syndrome in patients undergoing knee and hip arthroplasty: trends and in-hospital outcomes in the United States
J Arthroplasty
Quantifying cardiovascular risks in patients with metabolic syndrome undergoing total joint arthroplasty
J Arthroplasty
The interaction of obesity and metabolic syndrome in determining risk of complication following total joint arthroplasty
J Arthroplasty
Development and validation of perioperative risk-adjustment models for hip fracture repair, total hip arthroplasty, and total knee arthroplasty
J Bone Joint Surg Am
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One or more of the authors of this paper have disclosed potential or pertinent conflicts of interest, which may include receipt of payment, either direct or indirect, institutional support, or association with an entity in the biomedical field which may be perceived to have potential conflict of interest with this work. For full disclosure statements refer to http://dx.doi.org/10.1016/j.arth.2016.08.007.