Obesity is associated with increased postoperative complications after operative management of distal humerus fractures
Background Distal humerus fractures commonly require surgical intervention, including open reduction and internal fixation (ORIF) and, more recently in elderly, low-demand individuals, total elbow arthroplasty (TEA). The association of obesity with complications after either of these procedures has...
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| Veröffentlicht in: | Journal of shoulder and elbow surgery 2015-10, Vol.24 (10), p.1602-1606 |
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| creator | Werner, Brian C., MD Rawles, Robert B., MD Jobe, J. Taylor, MD Chhabra, A. Bobby, MD Freilich, Aaron M., MD |
| description | Background Distal humerus fractures commonly require surgical intervention, including open reduction and internal fixation (ORIF) and, more recently in elderly, low-demand individuals, total elbow arthroplasty (TEA). The association of obesity with complications after either of these procedures has not previously been examined. Methods A national insurance database was queried for ORIF or TEA for management of a distal humerus fracture using procedural and diagnostic codes. Patients in each operative group were then divided into nonobese and obese cohorts. These cohorts were then queried for postoperative complications within 90 days after the surgical procedure using diagnostic and procedural codes. χ2 tests were calculated to determine statistical significance, with P |
| doi_str_mv | 10.1016/j.jse.2015.04.019 |
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| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1713952570</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S1058274615002542</els_id><sourcerecordid>1713952570</sourcerecordid><originalsourceid>FETCH-LOGICAL-c478t-fe4982989d19c8f5bbe961ba1714a52c06d75e393806bd4a1df31af013952e353</originalsourceid><addsrcrecordid>eNp9kU2L1jAUhYsozof-ADeSpZt2btKmbRAEGUZnYGAW6jqk6a2T2jY1N53h_femvKOCC1f3XnLOgTwny95wKDjw-mIsRsJCAJcFVAVw9Sw75bIUeS0BnqcdZJuLpqpPsjOiEQBUBeJldiJqXpeihdPs8a5DcvHAHDFD5K0zEXv26OI9c4sNaCidq6foVwwmugdk1s_r5Gw6_JJcQ8TA_r7OZjHfccYlMj-w3lE0E7vfZgwbsSEYG7eA9Cp7MZiJ8PXTPM--fbr6enmd3959vrn8eJvbqmljPmClWqFa1XNl20F2Haqad4Y3vDJSWKj7RmKpyhbqrq8M74eSmwF4qaTAUpbn2btj7hr8zw0p6tmRxWkyC_qNdArapbKBJOVHqQ2eKOCg1-BmEw6ag95561En3nrnraHSiXfyvH2K37oZ-z-O34CT4P1RgOmTDw6DJutwsdi7gDbq3rv_xn_4x20ntyT00w88II1-C0uip7kmoUF_2Qvf--apfyErUf4CmyioAA</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1713952570</pqid></control><display><type>article</type><title>Obesity is associated with increased postoperative complications after operative management of distal humerus fractures</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals</source><creator>Werner, Brian C., MD ; Rawles, Robert B., MD ; Jobe, J. Taylor, MD ; Chhabra, A. Bobby, MD ; Freilich, Aaron M., MD</creator><creatorcontrib>Werner, Brian C., MD ; Rawles, Robert B., MD ; Jobe, J. Taylor, MD ; Chhabra, A. Bobby, MD ; Freilich, Aaron M., MD</creatorcontrib><description>Background Distal humerus fractures commonly require surgical intervention, including open reduction and internal fixation (ORIF) and, more recently in elderly, low-demand individuals, total elbow arthroplasty (TEA). The association of obesity with complications after either of these procedures has not previously been examined. Methods A national insurance database was queried for ORIF or TEA for management of a distal humerus fracture using procedural and diagnostic codes. Patients in each operative group were then divided into nonobese and obese cohorts. These cohorts were then queried for postoperative complications within 90 days after the surgical procedure using diagnostic and procedural codes. χ2 tests were calculated to determine statistical significance, with P < .05 considered significant. Results A total of 6928 patients who underwent operative management of a distal humerus fracture were identified, including 4215 ORIF and 2713 TEA procedures. The obese ORIF patients had a significantly increased risk of 90-day local (odds ratio [OR], 2.5; P < .0001) and systemic (OR, 5.9; P < .0001) complications. The rates of postoperative infection, venous thromboembolism, and medical complications were significantly higher in the obese ORIF cohort than in nonobese patients. The obese TEA patients had a significantly increased risk of 90-day local (OR, 2.6; P < .0001) and systemic (OR, 4.4; P < .0001) complications. The rates of postoperative infection, venous thromboembolism, and medical complications were higher in the obese TEA cohort than in nonobese patients. Conclusions Obesity is associated with significantly higher rates of complications after ORIF and TEA for distal humerus fractures than in nonobese patients.</description><identifier>ISSN: 1058-2746</identifier><identifier>EISSN: 1532-6500</identifier><identifier>DOI: 10.1016/j.jse.2015.04.019</identifier><identifier>PMID: 26163280</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Aged ; Aged, 80 and over ; Arthroplasty, Replacement, Elbow - adverse effects ; complications ; distal humerus fractures ; Elbow Joint - physiopathology ; Elbow Joint - surgery ; Female ; Fracture Fixation, Internal - adverse effects ; Humans ; Humeral Fractures - surgery ; Infection - epidemiology ; Infection - etiology ; Male ; Obesity ; Obesity - epidemiology ; open reduction and internal fixation ; Orthopedics ; total elbow arthroplasty ; Treatment Outcome ; United States - epidemiology ; Venous Thromboembolism - epidemiology ; Venous Thromboembolism - etiology</subject><ispartof>Journal of shoulder and elbow surgery, 2015-10, Vol.24 (10), p.1602-1606</ispartof><rights>Journal of Shoulder and Elbow Surgery Board of Trustees</rights><rights>2015 Journal of Shoulder and Elbow Surgery Board of Trustees</rights><rights>Copyright © 2015 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c478t-fe4982989d19c8f5bbe961ba1714a52c06d75e393806bd4a1df31af013952e353</citedby><cites>FETCH-LOGICAL-c478t-fe4982989d19c8f5bbe961ba1714a52c06d75e393806bd4a1df31af013952e353</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S1058274615002542$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26163280$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Werner, Brian C., MD</creatorcontrib><creatorcontrib>Rawles, Robert B., MD</creatorcontrib><creatorcontrib>Jobe, J. Taylor, MD</creatorcontrib><creatorcontrib>Chhabra, A. Bobby, MD</creatorcontrib><creatorcontrib>Freilich, Aaron M., MD</creatorcontrib><title>Obesity is associated with increased postoperative complications after operative management of distal humerus fractures</title><title>Journal of shoulder and elbow surgery</title><addtitle>J Shoulder Elbow Surg</addtitle><description>Background Distal humerus fractures commonly require surgical intervention, including open reduction and internal fixation (ORIF) and, more recently in elderly, low-demand individuals, total elbow arthroplasty (TEA). The association of obesity with complications after either of these procedures has not previously been examined. Methods A national insurance database was queried for ORIF or TEA for management of a distal humerus fracture using procedural and diagnostic codes. Patients in each operative group were then divided into nonobese and obese cohorts. These cohorts were then queried for postoperative complications within 90 days after the surgical procedure using diagnostic and procedural codes. χ2 tests were calculated to determine statistical significance, with P < .05 considered significant. Results A total of 6928 patients who underwent operative management of a distal humerus fracture were identified, including 4215 ORIF and 2713 TEA procedures. The obese ORIF patients had a significantly increased risk of 90-day local (odds ratio [OR], 2.5; P < .0001) and systemic (OR, 5.9; P < .0001) complications. The rates of postoperative infection, venous thromboembolism, and medical complications were significantly higher in the obese ORIF cohort than in nonobese patients. The obese TEA patients had a significantly increased risk of 90-day local (OR, 2.6; P < .0001) and systemic (OR, 4.4; P < .0001) complications. The rates of postoperative infection, venous thromboembolism, and medical complications were higher in the obese TEA cohort than in nonobese patients. Conclusions Obesity is associated with significantly higher rates of complications after ORIF and TEA for distal humerus fractures than in nonobese patients.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Arthroplasty, Replacement, Elbow - adverse effects</subject><subject>complications</subject><subject>distal humerus fractures</subject><subject>Elbow Joint - physiopathology</subject><subject>Elbow Joint - surgery</subject><subject>Female</subject><subject>Fracture Fixation, Internal - adverse effects</subject><subject>Humans</subject><subject>Humeral Fractures - surgery</subject><subject>Infection - epidemiology</subject><subject>Infection - etiology</subject><subject>Male</subject><subject>Obesity</subject><subject>Obesity - epidemiology</subject><subject>open reduction and internal fixation</subject><subject>Orthopedics</subject><subject>total elbow arthroplasty</subject><subject>Treatment Outcome</subject><subject>United States - epidemiology</subject><subject>Venous Thromboembolism - epidemiology</subject><subject>Venous Thromboembolism - etiology</subject><issn>1058-2746</issn><issn>1532-6500</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kU2L1jAUhYsozof-ADeSpZt2btKmbRAEGUZnYGAW6jqk6a2T2jY1N53h_femvKOCC1f3XnLOgTwny95wKDjw-mIsRsJCAJcFVAVw9Sw75bIUeS0BnqcdZJuLpqpPsjOiEQBUBeJldiJqXpeihdPs8a5DcvHAHDFD5K0zEXv26OI9c4sNaCidq6foVwwmugdk1s_r5Gw6_JJcQ8TA_r7OZjHfccYlMj-w3lE0E7vfZgwbsSEYG7eA9Cp7MZiJ8PXTPM--fbr6enmd3959vrn8eJvbqmljPmClWqFa1XNl20F2Haqad4Y3vDJSWKj7RmKpyhbqrq8M74eSmwF4qaTAUpbn2btj7hr8zw0p6tmRxWkyC_qNdArapbKBJOVHqQ2eKOCg1-BmEw6ag95561En3nrnraHSiXfyvH2K37oZ-z-O34CT4P1RgOmTDw6DJutwsdi7gDbq3rv_xn_4x20ntyT00w88II1-C0uip7kmoUF_2Qvf--apfyErUf4CmyioAA</recordid><startdate>20151001</startdate><enddate>20151001</enddate><creator>Werner, Brian C., MD</creator><creator>Rawles, Robert B., MD</creator><creator>Jobe, J. Taylor, MD</creator><creator>Chhabra, A. Bobby, MD</creator><creator>Freilich, Aaron M., MD</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20151001</creationdate><title>Obesity is associated with increased postoperative complications after operative management of distal humerus fractures</title><author>Werner, Brian C., MD ; Rawles, Robert B., MD ; Jobe, J. Taylor, MD ; Chhabra, A. Bobby, MD ; Freilich, Aaron M., MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c478t-fe4982989d19c8f5bbe961ba1714a52c06d75e393806bd4a1df31af013952e353</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Arthroplasty, Replacement, Elbow - adverse effects</topic><topic>complications</topic><topic>distal humerus fractures</topic><topic>Elbow Joint - physiopathology</topic><topic>Elbow Joint - surgery</topic><topic>Female</topic><topic>Fracture Fixation, Internal - adverse effects</topic><topic>Humans</topic><topic>Humeral Fractures - surgery</topic><topic>Infection - epidemiology</topic><topic>Infection - etiology</topic><topic>Male</topic><topic>Obesity</topic><topic>Obesity - epidemiology</topic><topic>open reduction and internal fixation</topic><topic>Orthopedics</topic><topic>total elbow arthroplasty</topic><topic>Treatment Outcome</topic><topic>United States - epidemiology</topic><topic>Venous Thromboembolism - epidemiology</topic><topic>Venous Thromboembolism - etiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Werner, Brian C., MD</creatorcontrib><creatorcontrib>Rawles, Robert B., MD</creatorcontrib><creatorcontrib>Jobe, J. Taylor, MD</creatorcontrib><creatorcontrib>Chhabra, A. Bobby, MD</creatorcontrib><creatorcontrib>Freilich, Aaron M., MD</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of shoulder and elbow surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Werner, Brian C., MD</au><au>Rawles, Robert B., MD</au><au>Jobe, J. Taylor, MD</au><au>Chhabra, A. Bobby, MD</au><au>Freilich, Aaron M., MD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Obesity is associated with increased postoperative complications after operative management of distal humerus fractures</atitle><jtitle>Journal of shoulder and elbow surgery</jtitle><addtitle>J Shoulder Elbow Surg</addtitle><date>2015-10-01</date><risdate>2015</risdate><volume>24</volume><issue>10</issue><spage>1602</spage><epage>1606</epage><pages>1602-1606</pages><issn>1058-2746</issn><eissn>1532-6500</eissn><abstract>Background Distal humerus fractures commonly require surgical intervention, including open reduction and internal fixation (ORIF) and, more recently in elderly, low-demand individuals, total elbow arthroplasty (TEA). The association of obesity with complications after either of these procedures has not previously been examined. Methods A national insurance database was queried for ORIF or TEA for management of a distal humerus fracture using procedural and diagnostic codes. Patients in each operative group were then divided into nonobese and obese cohorts. These cohorts were then queried for postoperative complications within 90 days after the surgical procedure using diagnostic and procedural codes. χ2 tests were calculated to determine statistical significance, with P < .05 considered significant. Results A total of 6928 patients who underwent operative management of a distal humerus fracture were identified, including 4215 ORIF and 2713 TEA procedures. The obese ORIF patients had a significantly increased risk of 90-day local (odds ratio [OR], 2.5; P < .0001) and systemic (OR, 5.9; P < .0001) complications. The rates of postoperative infection, venous thromboembolism, and medical complications were significantly higher in the obese ORIF cohort than in nonobese patients. The obese TEA patients had a significantly increased risk of 90-day local (OR, 2.6; P < .0001) and systemic (OR, 4.4; P < .0001) complications. The rates of postoperative infection, venous thromboembolism, and medical complications were higher in the obese TEA cohort than in nonobese patients. Conclusions Obesity is associated with significantly higher rates of complications after ORIF and TEA for distal humerus fractures than in nonobese patients.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>26163280</pmid><doi>10.1016/j.jse.2015.04.019</doi><tpages>5</tpages></addata></record> |
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| subjects | Aged Aged, 80 and over Arthroplasty, Replacement, Elbow - adverse effects complications distal humerus fractures Elbow Joint - physiopathology Elbow Joint - surgery Female Fracture Fixation, Internal - adverse effects Humans Humeral Fractures - surgery Infection - epidemiology Infection - etiology Male Obesity Obesity - epidemiology open reduction and internal fixation Orthopedics total elbow arthroplasty Treatment Outcome United States - epidemiology Venous Thromboembolism - epidemiology Venous Thromboembolism - etiology |
| title | Obesity is associated with increased postoperative complications after operative management of distal humerus fractures |
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