Body Mass Index as a Risk Factor for 30-Day Postoperative Complications in Knee, Hip, and Shoulder Arthroscopy

Nicolay, Richard W.; Selley, Ryan S.; Terry, Michael A.; Tjong, Vehniah K.

doi:10.1016/j.arthro.2018.10.108

Cited by 31 publications

(31 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Therefore, further investigation on associations of severity of myocardial infarction and APE in patients with OPCABG are required. Second, several previous studies 27,41,42 showed that BMI and diabetes were risk factors for pulmonary embolism. The sample size of our study was small, and it might not have had sufficient power to detect potential related risk factors.…”

Section: Discussionmentioning

confidence: 96%

Risk factors for acute pulmonary embolism in patients with off-pump coronary artery bypass grafting: implications for nursing

Zhou

Cao

et al. 2020

J Int Med Res

View full text Add to dashboard Cite

Objective Acute pulmonary embolism (APE) is a serious complication after off-pump coronary artery bypass grafting (OPCABG). We aimed to analyze the risk factors for APE in patients with OPCABG. Methods In this retrospective, observational study, patients with OPCABG who were treated in our hospital from 1 January 2018 to 31 March 2020 were included. The basic characteristics of patients and results of preoperative laboratory examinations were collected and analyzed. Results A total of 707 patients with OPCABG were included and the incidence of APE was 3.21%. Left ventricular ejection fraction (LVEF), a history of smoking, number of bypass grafting, duration of surgery, and age were significant risk factors for APE in patients with OPCABG. The areas under the curves of LVEF, number of bypass grafting, duration of surgery, and age were 0.773, 0.759, 0.738, and 0.723, respectively. The cutoff values of LVEF, number of bypass grafting, duration of surgery, and age were 59.84, 3.18, 237.42, and 73.28, respectively. Conclusions LVEF, a history of smoking, number of bypass grafting, duration of surgery, and age may be risk factors for APE in patients with OPCABG. Early measures should be taken to target these risks to prevent APE.

show abstract

Section: Discussionmentioning

confidence: 96%

Risk factors for acute pulmonary embolism in patients with off-pump coronary artery bypass grafting: implications for nursing

Zhou

Cao

et al. 2020

J Int Med Res

View full text Add to dashboard Cite

show abstract

“…Physicians may want to avoid further arthroscopic intervention in morbidly obese patients because they may experience a higher rate of complications following knee arthroscopy. 26 , 27 Therefore, revision arthroscopy might not be offered to patients with morbid obesity due to a theoretical increased risk of additional complications and failure. Morbid obesity was a risk factor for conversion to TKA in the Medicare database but not the Humana database.…”

Section: Discussionmentioning

confidence: 99%

Rates and Risk Factors of Revision Arthroscopy or Conversion to Total Knee Arthroplasty Within 1 Year Following Isolated Meniscectomy

Agarwalla

Gowd

Liu

et al. 2020

Arthroscopy, Sports Medicine, and Rehabilitation

View full text Add to dashboard Cite

Purpose To identify the rates of and risk factors for revision arthroscopy and conversion to total knee arthroplasty (TKA) within 1 year of isolated meniscectomy. Methods Humana and Medicare national insurance databases were queried for patients who underwent isolated meniscectomy. Patients who underwent revision arthroscopy or TKA within 1 year postoperatively were identified by International Classification of Diseases Procedural Codes, Ninth Revision, and Current Procedural Terminology codes. Multivariate binomial logistic regression analysis was used to identify risk factors, and adjusted odds ratios (ORs) and 95% confidence intervals (Cis) were calculated, with P < .05 considered significant. Results A total of 13,142 patients and 407,888 patients underwent isolated meniscectomy in the Humana and Medicare databases, respectively. Of the patients, 395 (3.01%) and 3,770 patients (0.92%) underwent revision arthroscopy, and 629 patients (4.79%) and 38,630 patients (9.47%) underwent TKA within 1 year of meniscectomy in the Humana and Medicare databases, respectively. Obesity (Humana: OR = 1.33, P = 0.003; Medicare: OR = 1.10, P < 0.001) and age < 20 years (Humana: OR = 2.64, P = 0.022), 20-29 years (Humana: OR = 3.30, P = 0.002), 40-49 years (Humana: OR = 3.80, P < 0.001), 50-59 years (Humana: OR = 1.99, P = 0.027), and < 64 years (Medicare: OR = 1.74, P < 0.001) were risk factors for revision arthroscopy. Obesity (Humana: OR = 1.64, P < 0.001; Medicare: OR = 1.37, P < 0.001), morbid obesity (Medicare: OR = 1.20, P < 0.001), age 70-74 (Medicare: OR = 1.12, P < 0.001), 75-79 (Medicare: OR = 1.25, P < 0.001), 80-84 (Medicare: OR = 1.20, P < 0.001), and concomitant osteoarthritis (Humana: OR = 1.42, P < 0.001; Medicare: OR = 1.46, P < 0.001) were risk factors for conversion to TKA. Conclusions Medicare and Humana databases showed that 0.92%-3.01% and 4.79%-9.47% of patients undergo revision arthroscopy or conversion to TKA within a year of isolated meniscectomy. Obesity was a risk factor for early revision arthroscopy and conversion to TKA, whereas concomitant osteoarthritis was a risk factor for conversion to TKA. Level of Evidence Level III, retrospective comparative trial .

show abstract

“…[7][8][9][10] On the other side of the equation, using BMI to categorize body habitus may lead to different results depending on the cutoffs used. 11 Nicolay et al 1 took on these challenges and used the NSQIP database to generate estimates of risk according to BMI in 141,335 patients. Nicolay et al carefully built their model, starting with a univariate analysis to identify potential risk factors, followed by a multivariate analysis to determine which factors are independently predictive of complications.…”

Section: See Related Article On Page 874mentioning

confidence: 99%

“…How do these results fit with what has already been shown? Nicolay et al 1 used the World Health Organization classification of body habitus and found class III obese patients with diabetes at risk of readmission, yet a similar study that used NSQIP data and categorized obesity by BMI as less than 35 versus 35 or greater found just the opposite. 12 The same goes for Nicolay et al and Martin et al, 13 both of whom examined 30day morbidity in elective shoulder arthroscopy The late statistician George Box noted, "The most that can be expected from any model is that it can supply a useful approximation to reality: All models are wrong; some models are useful."…”

Section: See Related Article On Page 874mentioning

confidence: 99%

“…12 The same goes for Nicolay et al and Martin et al, 13 both of whom examined 30day morbidity in elective shoulder arthroscopy The late statistician George Box noted, "The most that can be expected from any model is that it can supply a useful approximation to reality: All models are wrong; some models are useful." 15 This sage wisdom applies to the study of Nicolay et al 1 Despite a well-constructed analysis, their model, like all models, is a simplified generalization of reality. However, when approached from the perspective of utility, their research provides some insight.…”

Section: See Related Article On Page 874mentioning

confidence: 99%

See 1 more Smart Citation

Editorial Commentary: Complications and Readmission After Elective Arthroscopy—Is Body Mass Index a Trustworthy Measure of Risk?

Cote¹

2019

Arthroscopy: The Journal of Arthroscopic & Related Surgery

View full text Add to dashboard Cite

A multivariate analysis of the American College of Surgeons National Surgical Quality Improvement Program database indicates that body mass index is not predictive of complications after elective arthroscopy; however, further analysis reveals underweight and obese patients may be at risk of 30-day morbidity or readmission after shoulder arthroscopy. These findings are consistent with previous reports yet conflict with others, raising concern over the utility of body mass index as a measure of the risk of morbidity and readmission after elective arthroscopy.

show abstract

Body Mass Index as a Risk Factor for 30-Day Postoperative Complications in Knee, Hip, and Shoulder Arthroscopy

Cited by 31 publications

References 20 publications

Risk factors for acute pulmonary embolism in patients with off-pump coronary artery bypass grafting: implications for nursing

Risk factors for acute pulmonary embolism in patients with off-pump coronary artery bypass grafting: implications for nursing

Rates and Risk Factors of Revision Arthroscopy or Conversion to Total Knee Arthroplasty Within 1 Year Following Isolated Meniscectomy

Editorial Commentary: Complications and Readmission After Elective Arthroscopy—Is Body Mass Index a Trustworthy Measure of Risk?

Contact Info

Product

Resources

About