The influence of body mass index on life quality and clinical improvement after total hip arthroplasty

Zhang, Ziji; Zhao, Xiaoyi; Kang, Yan; Zhang, Zhiqi; Zhong, Yaping; He, Anbang; Fu, Ming; Sheng, Puyi; Liao, Weiming

doi:10.1007/s00776-012-0197-9

Cited by 22 publications

(17 citation statements)

References 28 publications

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“…Furthermore, Zhang et al. [3] observed that these types of patients had a greater number of revisions and complications, similar to the rates found in high BMI patients. Although both UW and NW patients demonstrated similar amounts of blood loss after TKA, the preoperative Hb and Hct levels were significantly lower for UW patients, thus placing them at higher risk of needing a transfusion postoperatively.…”

Section: Discussionsupporting

confidence: 73%

“…Most studies have focused on obese patients, as they comprise 34.9% of the adult population in the United States [1]. These patients have increased readmission rates, a higher incidence of infections, and greater complication rates compared to normal weight (NW) patients [2], [3], [4], [5], [6], [7]. However, much less is known regarding the outcomes of underweight (UW) surgical patients, since they only make up 2.3% of the US population and 0%-3.66% of patients in European nations [8], [9].…”

Section: Introductionmentioning

confidence: 99%

“…With regard to total joint arthroplasty, UW total hip arthroplasty (THA) patients have been identified as having a higher incidence of infection, transfusion, dislocation, readmission, and mortality [2], [3], [4], [14], [15]. These patients also have been reported to have lower postoperative functional health scores [16].…”

Section: Introductionmentioning

confidence: 99%

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Surgical site infection and transfusion rates are higher in underweight total knee arthroplasty patients

et al. 2017

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BackgroundUnderweight (UW) patients undergoing total hip arthroplasty have exhibited higher complication rates, including infection and transfusion. No study to our knowledge has evaluated UW total knee arthroplasty (TKA) patients. We, therefore, conducted a study to investigate if these patients are at increased risk for complications, including infection and transfusion.MethodsA case-control study was conducted using a prospectively collected institutional database. Twenty-seven TKA patients were identified as UW (body mass index [BMI] < 18.5 kg/m2) from 2000-2012 and were matched for age, gender, date of surgery, age-adjusted Charlson comorbidity index, rheumatoid arthritis, and diabetes. These patients were compared to 81 normal weight patients (BMI 18.5-24 kg/m2). Demographic variables were compared, along with wound complications, surgical site infection (SSI), blistering, deep vein thrombosis, pulmonary embolism, transfusion, revision, flexion contracture, hematoma formation, and patellar clunk.ResultsThe average BMI was 17.1 kg/m2 (range 12.8-18.4) for UW and 23.0 kg/m2 (range 19.0-25.0) for normal weight patients (P < .001). UW TKA patients were more likely to develop SSIs (3/27, 11.1% vs 0/81, 0.0%, P = .01) and were more likely to require transfusions (odds ratio = 3.4, confidence interval 1.3-9.1; P = .02).ConclusionsOur study demonstrates that UW TKA patients have a higher likelihood of developing SSI and requiring blood transfusions. The specific reasons are unclear, but we conjecture that it may be related to decreased wound healing capabilities and low preoperative hemoglobin. Investigation of local tissue coverage and hematologic status may be beneficial in this patient population to prevent SSI. Based on the results of this study, a prospective evaluation of these factors should be undertaken.

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Section: Discussionsupporting

confidence: 73%

Section: Introductionmentioning

confidence: 99%

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Surgical site infection and transfusion rates are higher in underweight total knee arthroplasty patients

et al. 2017

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“…2,[97][98][99]189,190 It is surprising then that obese patients (BMI ≥ 25.0) were less likely to be prescribed mechanical prophylaxis than non-obese patients in this study. This may be due to difficulties that can arise from fitting stockings on obese patients.…”

Section: Discussionmentioning

confidence: 45%

Thromboprophylaxis following hip and knee arthroplasty

Mirkazemi

Bereznicki

Peterson

2013

Internal Medicine Journal

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Aim To determine local thromboprophylaxis prescribing practices following arthroplasty. Methods A retrospective review was performed of 300 consecutive hip and knee arthroplasty patients (150 each) over a 2‐year period at Tasmania's major public hospital. The provision of thromboprophylaxis, the presence of bleeding/thrombotic risk factors and the prevalence of symptomatic venous thromboembolism (VTE) and major bleeding occurring within 90 days postoperatively were documented. Results The mean age of the 300 patients (169 females, 131 males) was 68.7 years (standard deviation 10.4). Only 11.3% of knee arthroplasty and 16.7% of hip arthroplasty inpatients had mechanical thromboprophylaxis documented during their stay. All inpatients received pharmacological thromboprophylaxis, predominantly injectable anticoagulants (98.4%). Only 36.5% continued to receive pharmacological thromboprophylaxis following discharge, predominantly an antiplatelet agent (55.5%). The 90‐day incidence of symptomatic VTE was 2.7% (95% confidence interval: 1.0–5.0%); 4.0% (95% confidence interval: 1.0–8.0%) for knees and 1.3% (95% confidence interval: 0–5.0%) for hips. The in‐hospital and post‐discharge VTE incidence was 0.7% and 2.0% respectively. All readmissions for VTE occurred within 1 month of surgery. Conclusions While inpatient thromboprophylaxis was routine, it generally was not continued on discharge, potentially leaving many patients exposed to a higher risk of VTE. Most cases of symptomatic VTE occurred after discharge, with the majority requiring readmission to hospital under medical units.Within the limitations of a retrospective study, these findings suggest a need for further research and discussion regarding what constitutes appropriate thromboprophylaxis (type, agent and duration) following hip or knee arthroplasty.

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Section: Discussionmentioning

confidence: 70%