Abstract
Background: There is ongoing discussion about whether preoperative obesity is negatively associated with inpatient outcomes of total hip arthroplasty (THA). The aim was to investigate the interaction between obesity and muscle strength and the association with postoperative inpatient recovery after THA.
Methods: Preoperative obesity (body mass index [BMI] >30 kg/m(2)) and muscle weakness (hand grip strength 2 days to reach independence of walking) and prolonged length of hospital stay (LOS, >4 days and/or discharge to extended rehabilitation). Univariate and multivariable regression analyses with the independent variables muscle weakness and obesity, and the interaction between obesity and muscle weakness, were performed and corrected for possible confounders.
Results: Two hundred and ninety-seven patients were included, 54 (18%) of whom were obese and 21 (7%) who also had muscle weakness. Obesity was not significantly associated with prolonged LOS (odds ratio [OR] 1.36, 95% confidence interval [CI] 0.75-2.47) or prolonged recovery of activities (OR 1.77, 95% CI 0.98-3.22), but the combination of obesity and weakness was significantly associated with prolonged LOS (OR 3.59, 95% CI 1.09-11.89) and prolonged recovery of activities (OR 6.21, 95% CI 1.64-23.65).
Conclusion: Obesity is associated with inpatient recovery after THA only in patients with muscle weakness. The results of this study suggest that we should measure muscle strength in addition to BMI (or body composition) to identify patients at risk of prolonged LOS. (C) 2017 Elsevier Inc. All rights reserved.
Original language | English |
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Pages (from-to) | 1918-1922 |
Number of pages | 5 |
Journal | Journal of Arthroplasty |
Volume | 32 |
Issue number | 6 |
DOIs | |
Publication status | Published - Jun 2017 |
Keywords
- hip arthroplasty
- risk assessment
- body mass index
- length of stay
- muscle strength
- TOTAL JOINT ARTHROPLASTY
- HAND GRIP STRENGTH
- BODY-MASS INDEX
- SARCOPENIC OBESITY
- PROSPECTIVE COHORT
- SURGICAL OUTCOMES
- OLDER-ADULTS
- REPLACEMENT
- SURGERY
- PERFORMANCE