Brian C Werner1, Ahmad H Fashandi1, A Bobby Chhabra1, D Nicole Deal2. 1. Department of Orthopaedic Surgery, University of Virginia Health System, Charlottesville, Virginia, U.S.A. 2. Department of Orthopaedic Surgery, University of Virginia Health System, Charlottesville, Virginia, U.S.A.. Electronic address: dnd2t@hscmail.mcc.virginia.edu.
Abstract
PURPOSE: To use a national insurance database to explore the association of obesity with the incidence of complications after elbow arthroscopy in a Medicare population. METHODS: Using Current Procedural Terminology (CPT) and International Classification of Diseases, 9th Revision (ICD-9) procedure codes, we queried the PearlDiver database for patients undergoing elbow arthroscopy. Patients were divided into obese (body mass index [BMI] >30) and nonobese (BMI <30) cohorts using ICD-9 codes for BMI and obesity. Nonobese patients were matched to obese patients based on age, sex, tobacco use, diabetes, and rheumatoid arthritis. Postoperative complications were assessed with ICD-9 and Current Procedural Terminology codes, including infection, nerve injury, stiffness, and medical complications. RESULTS: A total of 2,785 Medicare patients who underwent elbow arthroscopy were identified from 2005 to 2012; 628 patients (22.5%) were coded as obese or morbidly obese, and 628 matched nonobese patients formed the control group. There were no differences between the obese patients and matched control nonobese patients regarding type of elbow arthroscopy, previous elbow fracture or previous elbow arthroscopy. Obese patients had greater rates of all assessed complications, including infection (odds ratio [OR] 2.8, P = .037), nerve injury (OR 5.4, P = .001), stiffness (OR 1.9, P = .016) and medical complications (OR 6.9, P < .0001). CONCLUSIONS: Obesity is associated with significantly increased rates of all assessed complications after elbow arthroscopy in a Medicare population, including infection, nerve injury, stiffness, and medical complications. LEVEL OF EVIDENCE: Therapeutic Level III, case-control study.
PURPOSE: To use a national insurance database to explore the association of obesity with the incidence of complications after elbow arthroscopy in a Medicare population. METHODS: Using Current Procedural Terminology (CPT) and International Classification of Diseases, 9th Revision (ICD-9) procedure codes, we queried the PearlDiver database for patients undergoing elbow arthroscopy. Patients were divided into obese (body mass index [BMI] >30) and nonobese (BMI <30) cohorts using ICD-9 codes for BMI and obesity. Nonobese patients were matched to obesepatients based on age, sex, tobacco use, diabetes, and rheumatoid arthritis. Postoperative complications were assessed with ICD-9 and Current Procedural Terminology codes, including infection, nerve injury, stiffness, and medical complications. RESULTS: A total of 2,785 Medicare patients who underwent elbow arthroscopy were identified from 2005 to 2012; 628 patients (22.5%) were coded as obese or morbidly obese, and 628 matched nonobese patients formed the control group. There were no differences between the obesepatients and matched control nonobese patients regarding type of elbow arthroscopy, previous elbow fracture or previous elbow arthroscopy. Obesepatients had greater rates of all assessed complications, including infection (odds ratio [OR] 2.8, P = .037), nerve injury (OR 5.4, P = .001), stiffness (OR 1.9, P = .016) and medical complications (OR 6.9, P < .0001). CONCLUSIONS:Obesity is associated with significantly increased rates of all assessed complications after elbow arthroscopy in a Medicare population, including infection, nerve injury, stiffness, and medical complications. LEVEL OF EVIDENCE: Therapeutic Level III, case-control study.
Authors: Christopher L Camp; Collin C Tebo; Ryan M Degen; Joshua S Dines; David W Altchek; Brian C Werner Journal: Orthop J Sports Med Date: 2018-05-15
Authors: Andreas Voss; Christian G Pfeifer; Maximilian Kerschbaum; Markus Rupp; Peter Angele; Volker Alt Journal: Knee Surg Sports Traumatol Arthrosc Date: 2021-03-23 Impact factor: 4.342