TY - JOUR
T1 - Obesity is associated with increased postoperative complications after operative management of proximal humerus fractures
AU - Werner, Brian C.
AU - Griffin, Justin W.
AU - Yang, Scott
AU - Brockmeier, Stephen F.
AU - Gwathmey, F. Winston
N1 - Publisher Copyright:
© 2015 Journal of Shoulder and Elbow Surgery Board of Trustees.
PY - 2015/4/1
Y1 - 2015/4/1
N2 - Background: Obesity has become a significant public health concern in the United States. The goal of this study was to assess the effect of obesity on postoperative complications after operative management of proximal humerus fractures by use of a national database. Methods: Patients who underwent operative management of a proximal humerus fracture were identified in a national database by Current Procedural Terminology codes for procedures in patients with International Classification of Diseases, Ninth Revision (ICD-9) codes for proximal humerus fracture, including (1) open reduction and internal fixation, (2) intramedullary nailing, (3) hemiarthroplasty, and (4) total shoulder arthroplasty. These groups were then divided into obese and nonobese cohorts by use of ICD-9 codes for obesity, morbid obesity, or body mass index >30. Each cohort was then assessed for local and systemic complications within 90days and mortality within 2years postoperatively. Odds ratios and 95% confidence intervals were calculated. Results: From 2005 to 2011, 20,319 patients who underwent operative management of proximal humerus fractures were identified, including 14,833 (73.0%) open reduction and internal fixation, 1368 (9.2%) intramedullary nail, 3391 (16.7%) hemiarthroplasty, and 727 (3.6%) shoulder arthroplasty. Overall, 3794 patients (18.7%) were coded as obese, morbidly obese, or body mass index >30. Ineachoperative group, obesity was associated with a substantial increase in local and systemic complications. Conclusions: Obesity and its resultant medical comorbidities are associated with increased rates of postoperative complications after operative management of proximal humerus fractures. Obese patients for whom operative management of proximal humerus fractures is planned should be counseled preoperatively about their increased risk for postoperative complications.
AB - Background: Obesity has become a significant public health concern in the United States. The goal of this study was to assess the effect of obesity on postoperative complications after operative management of proximal humerus fractures by use of a national database. Methods: Patients who underwent operative management of a proximal humerus fracture were identified in a national database by Current Procedural Terminology codes for procedures in patients with International Classification of Diseases, Ninth Revision (ICD-9) codes for proximal humerus fracture, including (1) open reduction and internal fixation, (2) intramedullary nailing, (3) hemiarthroplasty, and (4) total shoulder arthroplasty. These groups were then divided into obese and nonobese cohorts by use of ICD-9 codes for obesity, morbid obesity, or body mass index >30. Each cohort was then assessed for local and systemic complications within 90days and mortality within 2years postoperatively. Odds ratios and 95% confidence intervals were calculated. Results: From 2005 to 2011, 20,319 patients who underwent operative management of proximal humerus fractures were identified, including 14,833 (73.0%) open reduction and internal fixation, 1368 (9.2%) intramedullary nail, 3391 (16.7%) hemiarthroplasty, and 727 (3.6%) shoulder arthroplasty. Overall, 3794 patients (18.7%) were coded as obese, morbidly obese, or body mass index >30. Ineachoperative group, obesity was associated with a substantial increase in local and systemic complications. Conclusions: Obesity and its resultant medical comorbidities are associated with increased rates of postoperative complications after operative management of proximal humerus fractures. Obese patients for whom operative management of proximal humerus fractures is planned should be counseled preoperatively about their increased risk for postoperative complications.
KW - Hemiarthroplasty
KW - Humeral intramedullary nail
KW - Level III
KW - Obesity
KW - Open reduction and internal fixation
KW - Proximal humerus fracture
KW - Retrospective cohort design from large database
KW - Reverse total shoulder arthroplasty
KW - Treatment study
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U2 - 10.1016/j.jse.2014.08.028
DO - 10.1016/j.jse.2014.08.028
M3 - Article
C2 - 25440511
AN - SCOPUS:84925047787
SN - 1058-2746
VL - 24
SP - 593
EP - 600
JO - Journal of Shoulder and Elbow Surgery
JF - Journal of Shoulder and Elbow Surgery
IS - 4
ER -