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

Abstract

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.

Total Joint Arthroplasty in the Morbidly Obese: How Body Mass Index ≥40 Influences Patient Retention, Treatment Decisions, and Treatment Outcomes

“…Additionally, obesity has been found to be associated with higher rates of total joint arthroplasty (TJA) revision and 10-year mortality [7,8]. Furthermore, resource utilization is higher in obese patients, with longer surgical duration and hospital stay [11].…”

What Factors Influence Operative Time in Total Knee Arthroplasty? A 10-Year Analysis in a National Sample

“…We found that BMI and age significantly impact operative time. Yet, despite the aging population of the United States [23e25] and the ongoing obesity epidemic [26,27], operative time values have still been maintained within a narrow range. Additionally, we found that procedures with a resident involved led to significantly longer operative times, a finding previously demonstrated in the literature [9,10].…”

Patients' risk factors for periprosthetic joint infection in total hip arthroplasty: A systematic review and meta-analysis of 34 studies

“…Consistent with previous finding [27,18], our data showed that patients with a BMI greater than 40, 35, o r 30 had a 3.64, 2.46, or 2.02-fo ld higher risk of PJI co mpared with those counterparts with less BMI, respectively. Obese patients are more prone to increased risk of PJI in the peri-operative setting, which may be attributed to prolonged operative and anesthetic time, higher risk of colonizat ion for C. avidum in the groin [11], longer hospital stay and high readmission rates within 30 days [9]. Besides, being obese is usually correlated with higher presence of other commod ities including metabolic syndrome, wound dehiscence, and heart disease [1].…”

“…It is imperat ive that both the surgeons and patients understand and identify the modifiable risk factors prior to THA so that they could make prudent decisions in the perioperative management, mitigate the risk of PJI, and therefore decrease the enormous financial and social burden of PJI [1,9].…”

“…Treat ment for PJI usually consists of prolonged systemic use of antibiotics, debridement and surgery, which may pose substantial burden of compro mised function and impaired quality of life to patients [1,6]. Moreover, patients with PJI are associated with higher financial burden and greater med ical resource utilizat ion on the current health care system [9,4,10]. Therefore, identification of potential risk factors and the magnitude of its effects are of great value for early detection and reduction of the incidence of PJI.…”