Effect of Obesity on Risk Factors for Adverse Outcomes in Pa
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A recent study states that many medical comorbidities have less effect in obese patients than nonobese patients in predicting adverse outcomes though there are increased rates of adverse outcomes in obese patients.

The aim of this study by Spine was to determine the influence of obesity on risk factors for adverse outcomes after lumbar spine fusion (LSF).

Adult patients undergoing LSF were identified in the State Inpatient Database. Patients were identified as obese or nonobese using ICD-9 codes. Outcome variables were 90-day readmission, major medical complication, infection, and revision rates. Data were queried for demographics, comorbidities, surgery characteristics, and outcome variables. Logistic multivariate regression was utilized, serially testing interactions between obesity and other independent variables in separate models for each outcome.

A total of 262,153 patients were included: 31,062 obese and 231, 091 nonobese.

~~For major complications, obese patients had lower odds ratios (ORs) versus nonobese patients for cerebrovascular accident, diabetes with chronic complications, age ?65, congestive heart failure, history of myocardial infarction, renal disease, chronic pulmonary disease, Medicare/Medicaid payor, more than two levels fused, transforaminal/posterior lumbar interbody fusion, and female sex, and higher OR for the non-White race.

~~For readmission, obese patients had lower OR for age ?65, history of MI, renal disease, and mental health disease, and higher OR for the female sex.

~~For revision, obese patients had higher OR for female sex and TLIF/PLIF.

~~For infection, obese patients had lower OR for diabetes with and without chronic complications, and higher OR for the female sex.

In conclusion, these findings reflect the impact of obesity as an independent risk factor and have important implications for preoperative optimization.

Source: https://journals.lww.com/spinejournal/Abstract/2021/04010/The_Impact_of_Obesity_on_Risk_Factors_for_Adverse.13.aspx