目的:本研究评估了接受踝关节切开复位内固定(ORIF)的患者肥胖与术后并发症之间的关系。
方法:
方法:回顾性队列研究。
方法:PearlDiver-MarinerAll-Payor数据库。
■从2010年至2021年接受踝关节ORIF并至少随访2年的患者使用当前程序术语进行鉴定,ICD-9和ICD-10代码。
■根据体重指数将患者分层为非肥胖,肥胖,病态肥胖,和超级肥胖群体。并发症发生率,包括90天的再入院,感染,和创伤后骨关节炎,在肥胖组之间进行比较。另外,对患者进行了1:1匹配的分析,以控制人口统计学和合并症。
结果:从2010年到2021年,共有160,415例患者接受踝关节ORIF治疗。该队列主要由女性组成(64.8%),平均年龄为52.5(SD18.4)岁。90天的再入院率较高,UTI,DVT/PE,肺炎,浅表感染,和急性肾损伤患者的肥胖水平增加(P<0.001)。在2年的匹配分析中,肥胖组骨不愈合和创伤后关节炎的几率增加[OR:2.36,95%置信区间(CI):1.68-3.31,P<0.001;OR:2.18,95%CI:1.77-2.68,P<0.001]。
结论:接受踝关节ORIF治疗的患者术后并发症发生率,包括感染,肥胖患者的比例更高,即使在控制人口统计学和合并症因素的1:1匹配分析中也是如此。肥胖患者骨不连和创伤后关节炎的发生率更高,也是。因此,对于外科医生来说,就肥胖患者踝关节ORIF后的风险提供适当的教育非常重要.
方法:预后III级。有关证据级别的完整描述,请参阅作者说明。
OBJECTIVE: This study evaluated the relationship between obesity and postoperative complications in patients undergoing ankle open reduction internal fixation (ORIF).
METHODS: METHODS: Retrospective cohort study.
METHODS: PearlDiver-Mariner All-Payor Database.
UNASSIGNED: Patients who underwent ankle ORIF from 2010 to 2021 and had a minimum of 2 years of follow-up were identified using Current Procedural Terminology, ICD-9, and ICD-10 codes.
UNASSIGNED: Patients were stratified by body mass index into nonobese, obese, morbidly obese, and super-obese groups. Complication rates, including 90-day readmissions, infection, and post-traumatic osteoarthritis, were compared between obesity groups. Patients were additionally compared with a 1:1 matched analysis that controlled for demographics and comorbidities.
RESULTS: A total of 160,415 patients undergoing ankle ORIF from 2010 to 2021 were identified. The cohort consisted mostly of females (64.8%) and the average age was 52.5 (SD 18.4) years. There were higher rates of 90-day readmissions, UTIs, DVT/PE, pneumonia, superficial infections, and acute kidney injuries in patients with increasing levels of obesity (P < 0.001). There were increased odds of nonunion and post-traumatic arthritis in the matched analysis at 2 years in the obesity group [OR: 2.36, 95% confidence interval (CI): 1.68-3.31, P < 0.001; OR: 2.18, 95% CI: 1.77-2.68, P < 0.001, respectively].
CONCLUSIONS: Postoperative medical complication rates in patients undergoing ankle ORIF, including infection, are higher in obese patients, even in the 1:1 matched analysis that controlled for demographic and comorbidity factors. Rates of nonunion and post-traumatic arthritis were higher in obese patients, as well. As such, it is important for surgeons to provide appropriate education regarding the risks after ankle ORIF in patients with obesity.
METHODS: Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.