It has been shown that the preoperative modification of risk factors associated with obesity may reduce complications after total knee arthroplasty (TKA). However, the optimal method of doing so remains unclear. The aim of this study was to investigate whether a preoperative Risk Stratification Tool (RST) devised in our institution could reduce unexpected intensive care unit (ICU) transfers and 90-day emergency department (ED) visits, readmissions, and reoperations after TKA in obese patients. We retrospectively reviewed 1,614 consecutive patients undergoing primary unilateral TKA. Their mean age was 65.1 years (17.9 to 87.7) and the mean BMI was 34.2 kg/m2 (SD 7.7). All patients underwent perioperative optimization and monitoring using the RST, which is a validated calculation tool that provides a recommendation for postoperative ICU care or increased nursing support. Patients were divided into three groups: non-obese (BMI < 30 kg/m2, n = 512); obese (BMI 30 kg/m2 to 39.9 kg/m2, n = 748); and morbidly obese (BMI > 40 kg/m2, n = 354). Logistic regression analysis was used to evaluate the outcomes among the groups adjusted for age, sex, smoking, and diabetes.Aims
Methods
Previous research has indicated that preoperative modification of risk factors associated with obesity may reduce complications after TKA. However, the optimal method is still debated. This study aims to investigate whether a preoperative Risk Stratification Tool (RST) devised by our institution to optimize obese patients can reduce unexpected ICU transfers, and 90-day ED visits, readmissions, and reoperations. We retrospectively reviewed 1,724 consecutive risk stratified patients undergoing primary unilateral TKA. The mean age was 64.8 years and average body mass index (BMI) was 34.2 kg/m2. All patients underwent preoperative optimization using the RST. We first compared our primary variables of interest between obese (BMI>30, n=1,189) and non-obese patients (n=535). Patients were then divided into 3 groups (I-non-obese, II-obese (30–39.9 kg/m2) and III-morbidly obese ((>40 kg/m2)) and logistic regression was used to evaluate outcomes among the groups adjusted for age, sex, smoking history and diabetes.Introduction
Methods
