A new study has found a connection between obesity and an increased risk for surgery in orthopedic trauma patients. The study was published in the November issue of Journal of Bone & Joint Surgery (JBJS) entitled “The Relationship of Obesity to Increasing Health-Care Burden in the Setting of Orthopaedic Polytrauma.”

Researchers observed that obese patients had longer stays at the hospital and higher treatment costs. There was also more likelihood of being discharged to a care facility than going directly home from the hospital

According to their study, obesity now affects over 38 percent of the U.S. population. For this study, the team used computer tomography (CT) scans to assess truncal body mass index (BMI), which is the body fat volume in a patient’s midsection. The researchers were specifically looking to find if there was a possible relationship between obesity and an increasing healthcare burden in patients with multiple orthopedic traumas.

For this research, investigators identified 301 patients with multiple orthopedic injuries at a Level I trauma center within the time span of 2006-2011. Only patients whose truncal BMI measure above 30 kg/m2 were considered obese. Afterwards, obese patients were divided into two categories: class I, which included patients with a truncal BMI between 30 kg/m2 and 35 kg/m2 and class II, including patients with a truncal BMI above 35 kg/m2.

The results were the following:

• Obesity did increase the risk of surgery. 72% of the patients who were obese required surgical treatment, as opposed to only 55% of non-obese patients. The severity of obesity also influenced the patient’s risk for surgery. And even though 67% of Class I patients had surgery, 93.3% of Class II patients required surgery.
• A normal truncal BMI did lead to shorter hospital stays, as the average intensive care period was around 7.2 days and average hospital stay was around 12.4 days. For obese patients, the numbers rose to 9.7 days and 16.4 days, respectively.
• In total, hospital costs were $160,606.02 for patients with a healthier BMI, whereas obese patients amounted to $234,863.58.
• Class II patients were more likely to be discharged to a continuing care facility.

“Overall this study found an association between obesity and increased rates of lower-extremity injuries and orthopedic surgery,” explained study lead author and orthopedic surgeon Heather Licht, MD. “Obese patients had higher total hospital charges, longer intensive care unit and total hospital stays, and decreased rate of discharge. Even when patients have the same severity of injuries, resource utilization is higher among patients with obesity, compared to non-obese patients.”