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肥胖对关节置换手术结局的影响:一项比较研究。

Impact of Obesity on Joint Replacement Surgery Outcomes: A Comparative Study.

作者信息

Rahman Abdul, Abid Hasan Hafiz Muhammad, Ali Rahman, Ullah Hidayat, Ahmad Saeed, Saqib Muhammad

机构信息

Orthopaedic Surgery Unit One, Jinnah Hospita Lahore, Allama Iqbal Medical College, Lahore, PAK.

Department of Orthopaedic Surgery, Tehsil Head Quarter (THQ) Zafarwal District, Narowal, PAK.

出版信息

Cureus. 2025 Mar 15;17(3):e80623. doi: 10.7759/cureus.80623. eCollection 2025 Mar.

Abstract

BACKGROUND

Obesity negatively impacts joint health and poses challenges during joint replacement surgery, leading to less favorable postoperative outcomes.

OBJECTIVE

This study aims to assess the impact of obesity on postoperative outcomes following joint replacement surgery by comparing obese and non-obese patients.

METHODOLOGY

This prospective observational study was conducted from January 2022 to December 2023, including 186 patients, of which 93 were classified as obese (BMI > 30 kg/m²) and 93 as non-obese (BMI < 30 kg/m²). Data on postoperative complications, mobility, pain scores, comorbidities, and demographics were collected and analyzed using IBM SPSS Statistics for Windows, Version 25.0 (Released 2017; IBM Corp., Armonk, New York, United States). Multivariate logistic regression was employed to identify independent predictors of adverse outcomes.

RESULTS

The mean BMI was significantly higher in obese patients (34.8 ± 3.2 kg/m²) compared to non-obese patients (24.6 ± 2.1 kg/m²). Obese patients had a higher prevalence of severe osteoarthritis (45.16% vs. 26.88%, p = 0.008), longer hospital stays (7.6 ± 2.1 vs. 5.4 ± 1.7 days, p < 0.001), and an increased incidence of postoperative complications, including surgical site infections (11.83% vs. 4.30%, p = 0.05). Multivariate analysis revealed that obesity was an independent predictor of poor postoperative outcomes (OR: 2.40, 95% CI: 1.30-4.50, p = 0.005).

CONCLUSION

Obese patients experienced higher complication rates, greater postoperative discomfort, reduced mobility, and prolonged hospital stays compared to non-obese patients. These findings highlight the significant negative impact of obesity on joint replacement surgery outcomes and emphasize the need for tailored preoperative assessments, optimized perioperative care, and targeted rehabilitation strategies for obese patients.

摘要

背景

肥胖对关节健康产生负面影响,并在关节置换手术期间带来挑战,导致术后结果不太理想。

目的

本研究旨在通过比较肥胖和非肥胖患者,评估肥胖对关节置换手术后的术后结果的影响。

方法

这项前瞻性观察性研究于2022年1月至2023年12月进行,包括186名患者,其中93名被归类为肥胖(BMI>30kg/m²),93名被归类为非肥胖(BMI<30kg/m²)。收集术后并发症、活动能力、疼痛评分、合并症和人口统计学数据,并使用IBM SPSS Statistics for Windows,版本25.0(2017年发布;IBM公司,美国纽约州阿蒙克)进行分析。采用多因素逻辑回归来确定不良结果的独立预测因素。

结果

肥胖患者的平均BMI(34.8±3.2kg/m²)显著高于非肥胖患者(24.6±2.1kg/m²)。肥胖患者严重骨关节炎的患病率更高(45.16%对26.88%,p=0.008),住院时间更长(7.6±2.1天对5.4±1.7天,p<0.001),术后并发症的发生率增加,包括手术部位感染(11.83%对4.30%,p=0.05)。多因素分析显示,肥胖是术后不良结果的独立预测因素(比值比:2.40,95%置信区间:1.30 - 4.50,p=0.005)。

结论

与非肥胖患者相比,肥胖患者的并发症发生率更高,术后不适更严重,活动能力降低,住院时间延长。这些发现凸显了肥胖对关节置换手术结果的重大负面影响,并强调需要对肥胖患者进行针对性的术前评估、优化围手术期护理和有针对性的康复策略。

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