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Obese patients face increased risks for infection and dislocation following revision hip surgery
Date:5/8/2008

ined as obese, with a body mass index (BMI) of 30 or more. The standard range for a normal BMI, the ideal weight to height ratio, is between 18 and 25. To further assess the association between BMI and postoperative outcomes, patients were also examined in 4 BMI categories: less than 25; 25 to 29.9, defined as overweight; 30 to 34.9; and 35 or more.

Based on patient records and follow-up examinations, the researchers first documented the occurrence of one or more adverse events within 5 years after the first revision THA: surgical site infection, dislocation of the prosthetic hip, or re-revision surgery for any cause. They then relied on trusted, hip-specific clinical evaluations, including the Harris Hip Score (HHS), along with in-person and phone interviews with patients, to measure each subjects functional status, level of pain, and general satisfaction with the procedure 5 years later. Finally, researchers used statistical analyses, including incidence rates and hazard ratios, to compare the outcomes between obese and non-obese patients after revision THA.

Overall, 20 complications occurred in 17 (33 percent) of the 52 obese patients, compared with 18 events in 13 (9 percent) of the 152 non-obese patients. In terms of specific complications, the incident rate was 4 times higher for surgical site infection and 3.5 times higher for dislocation. Even more striking, the incidence rate for occurrence of one or more adverse events rose with rising BMI. This increase was small between normal and overweight patients1.5 times higher. Yet, it became significantly greater in the group with a BMI between 30 and 34.94.5 times higher than normal weight patients. And it escalated to an alarmingly increase in the group with a BMI of 35 or more10.9 times higher. In these calculations, adjustments were performed for age, sex, and preoperative health status.

For those patients scheduled for a 5 year follow-up visit, 83 percent of the obese patien
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Contact: Sean Wagner
swagner@wiley.com
781-388-8550
Wiley-Blackwell
Source:Eurekalert

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