Journal
JOURNAL OF ARTHROPLASTY
Volume 34, Issue 12, Pages 2884-+Publisher
CHURCHILL LIVINGSTONE INC MEDICAL PUBLISHERS
DOI: 10.1016/j.arth.2019.07.012
Keywords
bariatric surgery; complication; total hip arthroplasty; total knee arthroplasty; morbid obesity
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Funding
- National Natural Science Foundation of China, China [81702175, 81802222]
- Natural Science Foundation of Guangdong Province, China [2018A030310694]
- Project of Administration of Traditional Chinese Medicine of Guangdong Province [20191004]
- Medical Scientific Research Foundation of Guangdong Province [2018114214430383]
- Special Clinical Research in Health Industry in Shanghai [20184Y0054]
- Shanghai Sail Program [19YF1459200]
- Young Talent Support Project [17-JCJQ-QT-029]
- Beijing Science and Technology New Star [2018011]
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Background: Morbid obesity is an important risk factor for arthroplasty and also closely associated with worse postoperative outcomes. Bariatric surgery is effective in losing weight and decreasing comorbidities associated with obesity. However, no study had demonstrated the influence of bariatric surgery on the outcome of arthroplasty in a large population. Methods: We used 2006-2014 discharge records from the Nationwide Inpatient Sample, and identified study population and inpatient complications by International Classification of Diseases, 9th Revision, Clinical Modification diagnosis/procedure codes. Propensity score analysis was used to match total hip arthroplasty (THA) or total knee arthroplasty (TKA) patients with morbid obesity and THA or TKA patients with bariatric surgery. Results: Proportion of morbid obesity in both TKA and THA patients demonstrated a rising trend, while proportion of bariatric surgery in morbidly obese TKA and THA patients remains steady after 2007. For THA patients, there was fewer pulmonary embolism, more blood transfusion and anemia, and shorter length of stay in bariatric surgery group. For TKA patients, bariatric surgery group had a lower risk of pulmonary embolism, respiratory complications, death, and shorter length of stay, but bariatric surgery group had a higher risk of blood transfusion and anemia. Conclusion: There is evidence that bariatric surgery prior to arthroplasty, especially THA, appears to reduce rates of pulmonary complications and length of stay. But anemia and blood transfusion seem to be more common in patients with prior bariatric surgery. (C) 2019 Published by Elsevier Inc.
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