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Superobesity (body mass index >50 kg/m2) and complications after total shoulder arthroplasty: an incremental effect of increasing body mass index.
J Shoulder Elbow Surg. 2015 Dec; 24(12):1868-75.JS

Abstract

BACKGROUND

The prevalence of obesity in the United States continues to increase. Attention has recently turned to an emerging population of extremely overweight patients, termed superobese and defined as those with body mass index (BMI) ≥50 kg/m(2). The goal of this study was to use a national database to evaluate postoperative complication rates after total shoulder arthroplasty (TSA) in superobese patients and to compare patients of different BMI classes.

METHODS

Patients who underwent TSA or reverse TSA were identified in the PearlDiver database by International Classification of Diseases, Ninth Revision (ICD-9) codes. These patients were then divided into nonobese, obese, morbidly obese, and superobese cohorts by ICD-9 codes. Postoperative complications were assessed and compared between cohorts.

RESULTS

From 2005 to 2012, 144,239 unique patients who underwent TSA or reverse TSA were identified, including 105,661 nonobese patients, 23,864 obese patients, 13,759 morbidly obese patients, and 955 superobese patients. Superobese patients had a significantly higher rate of infection, dislocation, component loosening, revision shoulder arthroplasty, venous thromboembolism, and medical complications after shoulder arthroplasty compared with nonobese controls.

CONCLUSIONS

Obesity is associated with significantly increased rates of numerous complications after TSA, including infection, dislocation, component loosening, revision surgery, venous thromboembolism, and medical complications, compared with nonobese controls. Superobesity (BMI > 50 kg/m(2)) is associated with significantly increased rates of several complications compared with even obese and morbidly obese patients, including infection, component loosening, venous thromboembolism, and medical complications.

Authors+Show Affiliations

Department of Orthopaedic Surgery, University of Virginia Health System, Charlottesville, VA, USA.Department of Orthopaedic Surgery, University of Virginia Health System, Charlottesville, VA, USA.Department of Orthopaedic Surgery, University of Virginia Health System, Charlottesville, VA, USA.Department of Orthopaedic Surgery, University of Virginia Health System, Charlottesville, VA, USA. Electronic address: sfb2e@virginia.edu.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

26190668

Citation

Werner, Brian C., et al. "Superobesity (body Mass Index >50 Kg/m2) and Complications After Total Shoulder Arthroplasty: an Incremental Effect of Increasing Body Mass Index." Journal of Shoulder and Elbow Surgery, vol. 24, no. 12, 2015, pp. 1868-75.
Werner BC, Burrus MT, Browne JA, et al. Superobesity (body mass index >50 kg/m2) and complications after total shoulder arthroplasty: an incremental effect of increasing body mass index. J Shoulder Elbow Surg. 2015;24(12):1868-75.
Werner, B. C., Burrus, M. T., Browne, J. A., & Brockmeier, S. F. (2015). Superobesity (body mass index >50 kg/m2) and complications after total shoulder arthroplasty: an incremental effect of increasing body mass index. Journal of Shoulder and Elbow Surgery, 24(12), 1868-75. https://doi.org/10.1016/j.jse.2015.05.046
Werner BC, et al. Superobesity (body Mass Index >50 Kg/m2) and Complications After Total Shoulder Arthroplasty: an Incremental Effect of Increasing Body Mass Index. J Shoulder Elbow Surg. 2015;24(12):1868-75. PubMed PMID: 26190668.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Superobesity (body mass index >50 kg/m2) and complications after total shoulder arthroplasty: an incremental effect of increasing body mass index. AU - Werner,Brian C, AU - Burrus,M Tyrrell, AU - Browne,James A, AU - Brockmeier,Stephen F, Y1 - 2015/07/17/ PY - 2015/02/17/received PY - 2015/04/30/revised PY - 2015/05/04/accepted PY - 2015/7/21/entrez PY - 2015/7/21/pubmed PY - 2016/7/1/medline KW - Superobesity KW - complications KW - infection KW - reverse shoulder arthroplasty KW - revision shoulder arthroplasty KW - total shoulder arthroplasty SP - 1868 EP - 75 JF - Journal of shoulder and elbow surgery JO - J Shoulder Elbow Surg VL - 24 IS - 12 N2 - BACKGROUND: The prevalence of obesity in the United States continues to increase. Attention has recently turned to an emerging population of extremely overweight patients, termed superobese and defined as those with body mass index (BMI) ≥50 kg/m(2). The goal of this study was to use a national database to evaluate postoperative complication rates after total shoulder arthroplasty (TSA) in superobese patients and to compare patients of different BMI classes. METHODS: Patients who underwent TSA or reverse TSA were identified in the PearlDiver database by International Classification of Diseases, Ninth Revision (ICD-9) codes. These patients were then divided into nonobese, obese, morbidly obese, and superobese cohorts by ICD-9 codes. Postoperative complications were assessed and compared between cohorts. RESULTS: From 2005 to 2012, 144,239 unique patients who underwent TSA or reverse TSA were identified, including 105,661 nonobese patients, 23,864 obese patients, 13,759 morbidly obese patients, and 955 superobese patients. Superobese patients had a significantly higher rate of infection, dislocation, component loosening, revision shoulder arthroplasty, venous thromboembolism, and medical complications after shoulder arthroplasty compared with nonobese controls. CONCLUSIONS: Obesity is associated with significantly increased rates of numerous complications after TSA, including infection, dislocation, component loosening, revision surgery, venous thromboembolism, and medical complications, compared with nonobese controls. Superobesity (BMI > 50 kg/m(2)) is associated with significantly increased rates of several complications compared with even obese and morbidly obese patients, including infection, component loosening, venous thromboembolism, and medical complications. SN - 1532-6500 UR - https://www.unboundmedicine.com/medline/citation/26190668/Superobesity__body_mass_index_>50_kg/m2__and_complications_after_total_shoulder_arthroplasty:_an_incremental_effect_of_increasing_body_mass_index_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1058-2746(15)00291-8 DB - PRIME DP - Unbound Medicine ER -