The effect of body mass index on blood loss and complications in simultaneous bilateral total hip arthroplasty: A multicenter retrospective study

Cao, Guorui; Yang, Xiaolin; Chen, Yue; Tan, Honglue; Xu, Hong; Huang, Zeyu; Quan, Songtao; Yang, Minglu; Pei, Fuxing

doi:10.1177/23094990211061209

Cited by 9 publications

(6 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In fact, there are several current publications concerning BMI, blood loss and perioperative transfusions in orthopeadic surgeries. Presented studies do advocate for lower transfusion rates in obese and overweight patients [21][22][23][24]. Thus, our results of lower blood transfusion requirements in the group with the highest BMI align with these previous ndings.…”

Section: Discussionsupporting

confidence: 91%

The association of acetabulum fracture and mechanism of injury with BMI, days spend in hospital, blood loss, and surgery time – a retrospective analysis of 67 patients

Wójcicki,

Pielak,

Walus

et al. 2023

Preprint

View full text Add to dashboard Cite

Objective: The objective of this retrospective study was to investigate the association between acetabulum fractures, mechanism of injury, and variables such as BMI, duration of hospital stay, blood loss, and surgery time. By exploring these factors, we aim to enhance our understanding of the accompanying factors of pelvic fractures and their impact on the healing process and subsequent management. Methods: This study included 136 consecutive patients who were admitted for pelvic ring fracture surgery between 2017 and 2022. The data was collected prospectively at a single trauma center. . The inclusion criteria were acetabulum fractures and indications for operative treatment. The exclusion criteria were non-operative treatment for acetabular and pelvic ring fractures, fractures requiring primary total hip arthroplasty (THA), and periprosthetic acetabular fractures. Upon admission, all patients underwent evaluation using X-ray and computed tomography (CT) scans of the pelvis. Results: The present study found no statistically significant differences among the examined groups of patients with pelvic fractures in terms of BMI, surgery duration, length of hospital stay, and blood transfusion. However, two notable findings approached statistical significance. Firstly, patients who experienced a fall from height while sustaining a pelvic fracture required a higher number of blood transfusions (2.3 units) compared to other mechanisms of injury (Fig. 2D), which was close to achieving statistical significance (p=0.07). Secondly, patients undergoing posterior wall stabilization exhibited a significantly lower number of blood transfusions compared to other specific pelvic injuries (0.33 units per patient), approaching statistical significance (p=0.056). Conlusions: We firmly believe that our study has provided valuable insights into pelvic fractures and their association with the investigated factors. The findings indicate that factors such as BMI, time of surgery, blood loss, and duration of hospital stay are not directly correlated with the morphology of acetabular fractures, the presence of additional trauma, or the mechanism of injury. However, it is worth noting that many of our findings align with existing literature on the subject.

show abstract

Section: Discussionsupporting

confidence: 91%

The association of acetabulum fracture and mechanism of injury with BMI, days spend in hospital, blood loss, and surgery time – a retrospective analysis of 67 patients

Wójcicki,

Pielak,

Walus

et al. 2023

Preprint

View full text Add to dashboard Cite

show abstract

“…Despite the common assumption of higher intraoperative blood loss and blood transfusion rates in obese patients [35], our study illustrated that blood transfusion requirements tended to be higher among patients with BMI <25 as compared to BMI >30 kg/m 2 . Similar findings were observed in several orthopaedic and cardiothoracic surgeries [36,37], which could be explained by a possibly higher initial blood volume among patients with higher BMI. Finally, our study demonstrated no significant impact of BMI on the conversion rate to open surgery.…”

Section: Discussionsupporting

confidence: 86%

The impact of body mass index on oncological and surgical outcomes of patients undergoing nephrectomy: a systematic review and meta‐analysis

et al. 2023

View full text Add to dashboard Cite

ObjectiveTo perform a systematic review and meta‐analysis to evaluate the impact of body mass index (BMI) on oncological (primary) and surgical (secondary) outcomes of patients who underwent nephrectomy, as obesity or high BMI is a known risk factor for renal cell carcinoma (RCC) and predictor of poorer outcomes.MethodsStudies were identified from four electronic databases from database inception to 2 June 2021, according to the Preferred Reporting Items for Systematic Review and Meta‐analysis statement. The review protocol was registered in the International Prospective Register of Systematic Reviews with the identification number: CRD42021275124.ResultsA total of 18 studies containing 13 865 patients were identified for the final meta‐analysis. Regarding oncological outcomes, higher BMI predicted higher overall survival (BMI >25 vs BMI <25 kg/m2: hazard ratio [HR] 0.70, 95% confidence interval [CI] 0.58–0.85), cancer‐specific survival (BMI >25 vs BMI <25 kg/m2: HR 0.60, 95% CI 0.50–0.73; BMI 25–30 vs BMI <25 kg/m2: HR 0.46, 95% CI 0.23–0.95; BMI >30 vs BMI <25 kg/m2: HR 0.50, 95% CI 0.36–0.69), and recurrence‐free survival rates (BMI >25 vs BMI <25 kg/m2: HR 0.72, 95% CI 0.63–0.82; BMI 25–30 vs BMI <25 kg/m2: HR 0.59, 95% CI 0.42–0.82). Those with a lower BMI fared better in surgical outcomes, such as operation time and warm ischaemic time, although the absolute difference was minimal and unlikely to be clinically significant. There was no difference between groups for length of hospital stay, intraoperative or postoperative complications, blood transfusion requirements, and conversion to open surgery.ConclusionOur study suggests that a higher BMI is associated with improved long‐term oncological survival and similar perioperative outcomes as a lower BMI. More research into the underlying biological and physiological mechanisms will enable better understanding of the effect of BMI, beyond mere association, on post‐nephrectomy outcomes.

show abstract

“…Perhaps this is due to higher rates of CHF, pneumonia, and transfusion in non-obese patients during the first 90 days. Previous studies have found reduced mortality from CHF and pneumonia and decreased need for transfusion [ 17 , 24 , 25 ]. This decrease in mortality could reduce the amount of healthcare intervention required and, therefore, reduce the associated healthcare costs.…”

Section: Discussionmentioning

confidence: 99%

The Impact of Obesity on Total Hip Arthroplasty Outcomes: A Retrospective Matched Cohort Study

Aggarwal¹,

Sambandam²,

Wukich³

2022

Cureus

View full text Add to dashboard Cite

Previous research has shown that obesity is associated with worse postoperative outcomes. We aim to determine how rates of specific complications after total hip arthroplasty (THA) align with obesity status. We hypothesize that obese patients would have higher rates of complications and cost and thus have worse outcomes than non-obese patients. MethodsData were collected from a large commercial insurance database between 2011 and 2020. Patients underwent a hip replacement under current procedural terminology (CPT) and International Statistical Classification of Diseases (ICD-9/ICD-10) codes. Obese (defined as having a BMI of 30 kg/m 2 or higher) and non-obese patients were matched on age, gender, Charlson Comorbidity Index (CCI), and Elixhauser Comorbidity Index (ECI). Standardized complications and costs in one year were compared using unequal variance ttests. ResultsUnder CPT codes, 61,462 obese (45% male) and 61,462 non-obese patients (45% male) underwent a hip replacement. Obese patients had significantly higher rates of surgical site infection (SSI) (OR=1.193, p=0.0001), deep vein thrombosis (DVT) (OR=1.275, p=0.001), wound complication (OR=1.736, p<0.0001), hematoma (OR=1.242, p=0.0001), pulmonary embolism (OR=1.141, p=0.0355), UTI (OR=1.065, p=0.0016), and opioid prescriptions (OR=1.17, p<0.0001), and significantly lower rates of arrhythmia (OR=0.907, p<0.0001), congestive heart failure (CHF) (OR=0.863, p<0.0001), cardiac arrest (OR=0.637 p<0.0001), pneumonia (OR=0.795, p<0.0001), and transfusion (OR=0.777, p<0.0001). Furthermore, obese patients were significantly more likely to undergo revision within 10 years (OR=1.172, p<0.0001). Under ICD codes, 31,922 obese (45% male) and 31,922 non-obese patients (45% male) were included. Obese patients did not have a significant difference in total cost or drug cost. ConclusionsObese patients had significantly higher rates of infection, venous thromboembolic event, wound complication, hematoma, and opioid prescriptions but significantly lower rates of cardiac issues, pneumonia, and transfusion, after hip replacement. Additionally, there was no significant difference in total or drug cost. Therefore, this study did not support our hypothesis that obese patients have worse outcomes than non-obese patients, as there neither was a clear significant increase in complication rates nor a significant increase in costs. However, further research should be done to better understand the complex relationship between obesity and postoperative outcomes.

show abstract

The effect of body mass index on blood loss and complications in simultaneous bilateral total hip arthroplasty: A multicenter retrospective study

Cited by 9 publications

References 32 publications

The association of acetabulum fracture and mechanism of injury with BMI, days spend in hospital, blood loss, and surgery time – a retrospective analysis of 67 patients

The association of acetabulum fracture and mechanism of injury with BMI, days spend in hospital, blood loss, and surgery time – a retrospective analysis of 67 patients

The impact of body mass index on oncological and surgical outcomes of patients undergoing nephrectomy: a systematic review and meta‐analysis

The Impact of Obesity on Total Hip Arthroplasty Outcomes: A Retrospective Matched Cohort Study

Contact Info

Product

Resources

About