Level Of Obesity Is Directly Associated With Complications Following Arthroscopic Rotator Cuff Repair

Authors, Author Information and Article Contact

Alireza K. Nazemi1, MD; Kevin I. Kashanchi2, BS; David E. Komatsu1, PhD; Edward D. Wang1 MD

1Department of Orthopaedics and Rehabilitation, Stony Brook University 2Renaissance School of Medicine, Stony Brook University

 

Disclosure Statement: None of the authors has any funding sources, commercial, or financial conflicts of interest to declare.

Keywords
Obesity, rotator cuff repair, rotator cuff repair complications
Abstract

Background: The purpose of this study was to investigate the association between increasing levels of obesity and post-operative complications within 30 days of arthroscopic rotator cuff repair (ARCR).

Methods: We queried the American College of Surgeons National Surgical Quality Improvement Program database for all patients who underwent ARCR from 2015 to 2017. Patients were stratified into 3 cohorts according to their body mass index (BMI). Patients with a BMI < 30 kg/m2 were placed in the non-obese cohort, patients with a BMI between 30 and 40 kg/m2 were placed in the obese cohort, and patients with a BMI > 40 kg/m2 were placed in the morbidly obese cohort. Postoperative complications within 30 days of the procedure were collected. Multivariate logistic regression was used to investigate the relationship between increasing levels of obesity and postoperative complications.

Results: There were 18,521 patients included in this study. Of these patients, 9548 (51.6%) were non-obese, 7438 (40.2%) were obese, and 1535 (8.3%) were morbidly obese. A comparison among non-obese, obese, and morbidly obese patients showed increasing rates of medical complications (0.5% vs. 1.0% vs. 1.4%), pulmonary complications (0.1% vs. 0.3% vs. 0.5%), renal complications (0.0% vs. 0.1% vs. 0.2%), readmission (0.9% vs. 1.2% vs. 1.6%), nonhome discharge (0.4% vs. 0.5% vs. 1.2%), and overall complications (0.8% vs. 1.3% vs. 1.8%). In comparison to non-obesity, both obesity and morbid obesity were identified by multivariate analysis as significant predictors of medical complications (odds ratio [OR] of 1.72 and 2.16, respectively), pulmonary complications (OR of 2.66 and 4.06, respectively), and overall complications (OR of 1.52 and 1.77, respectively).

Conclusion: This study used a large national database to identify increasing levels of obesity as a risk factor for medical complications, pulmonary complications, and overall complications within 30 days of ARCR.

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