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The impact of obesity on resource utilization among patients undergoing total joint arthroplasty

International Orthopaedics volume 43, pages 269–274 (2019)Cite this article

Abstract

Purpose

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.

Methods

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.

Results

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.

Conclusion

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.

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Affiliations

  1. Cornell University, Ithaca, NY, 14850, USA

    Federico M. Girardi

  2. Hospital for Special Surgery, 535 East 70th St, New York, NY, 10021, USA

    Jiabin Liu, Alejandro Gonzalez Della Valle, Catherine MacLean & Stavros G. Memtsoudis

  3. First Affiliated Hospital of General Hospital of PLA, Beijing, 100048, People’s Republic of China

    Zhenggang Guo

Authors
  1. Federico M. Girardi
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  2. Jiabin Liu
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  3. Zhenggang Guo
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  4. Alejandro Gonzalez Della Valle
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  5. Catherine MacLean
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  6. Stavros G. Memtsoudis
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Corresponding author

Correspondence to Jiabin Liu.

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The authors declare that they have no conflict of interest.

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This article does not contain any studies with human participants or animals performed by any of the authors.

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Girardi, F.M., Liu, J., Guo, Z. et al. The impact of obesity on resource utilization among patients undergoing total joint arthroplasty. International Orthopaedics (SICOT) 43, 269–274 (2019). https://doi.org/10.1007/s00264-018-4059-8

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  • DOI: https://doi.org/10.1007/s00264-018-4059-8

Keywords

  • Obesity
  • Body mass index
  • Resource utilization
  • Total knee arthroplasty
  • Total hip arthroplasty