Body mass index (BMI) and risk of noncardiac postoperative medical complications in elderly hip fracture patients: A population-based study

John A. Batsis, Jeanne M. Huddleston, L. Joseph Melton, Paul M. Huddleston, Dirk R. Larson, Rachel E. Gullerud, M. Molly McMahon

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

BACKGROUND: Obese patients are thought to be at higher risk of postoperative medical complications. We determined whether body mass index (BMI) is associated with postoperative in-hospital noncardiac complications following urgent hip fracture repair. METHODS: We conducted a population-based study of Olmsted County, Minnesota, residents operated on for hip fracture in 1988 to 2002. BMI was categorized as underweight (<18.5 kg/m2), normal (18.5-24.9 kg/m2), overweight (25.0-29.9 kg/m2), and obese (≥30 kg/m2). Postoperative inpatient noncardiac medical complications were assessed. Complication rates were estimated for each BMI category and overall rates were assessed using logistic regression modeling. RESULTS: There were 184 (15.6%) underweight, 640 (54.2%) normal, 251 (21.3%) overweight, and 105 (8.9%) obese hip fracture repairs (mean age, 84.2 ± 7.5 years; 80% female). After adjustment, the risk of developing an inpatient noncardiac complication for each BMI category, compared to normal BMI, was: underweight (odds ratio [OR], 1.33; 95% confidence interval [CI], 0.95-1.88; P = 0.10), overweight (OR, 1.01; 95% CI, 0.74-1.38; P = 0.95), and obese (OR, 1.28; 95% CI, 0.82-1.98; P = 0.27). Multivariate analysis demonstrated that an ASA status of III-V vs. I-II (OR, 1.84; 95% CI, 1.25-2.71; P = 0.002), a history of chronic obstructive pulmonary disease (COPD) or asthma (OR, 1.58; 95% CI, 1.18-2.12; P = 0.002), male sex (OR, 1.49; 95% CI, 1.10-2.02; P = 0.01), and older age (OR, 1.05; 95% CI, 1.03-1.06; P < 0.001) contributed to an increased risk of developing a postoperative noncardiac inpatient complication. Underweight patients had higher in-hospital mortality rates than normal BMI patients (9.3 vs. 4.4%; P = 0.01). CONCLUSIONS: BMI has no significant influence on postoperative noncardiac medical complications in hip-fracture patients. These results attenuate concerns that obese or frail, underweight hip-fracture patients may be at higher risk postoperatively for inpatient complications.

Original languageEnglish (US)
JournalJournal of Hospital Medicine
Volume4
Issue number8
DOIs
StatePublished - Oct 2009

Fingerprint

Hip Fractures
Thinness
Body Mass Index
Odds Ratio
Confidence Intervals
Inpatients
Population
Sex Ratio
Hospital Mortality
Chronic Obstructive Pulmonary Disease
Multivariate Analysis
Asthma
Logistic Models
Mortality

Keywords

  • Elderly
  • Hip fractures
  • Inpatient
  • Medical complications
  • Obesity
  • Postoperative

ASJC Scopus subject areas

  • Health Policy
  • Assessment and Diagnosis
  • Care Planning
  • Fundamentals and skills
  • Leadership and Management

Cite this

Batsis, J. A., Huddleston, J. M., Melton, L. J., Huddleston, P. M., Larson, D. R., Gullerud, R. E., & McMahon, M. M. (2009). Body mass index (BMI) and risk of noncardiac postoperative medical complications in elderly hip fracture patients: A population-based study. Journal of Hospital Medicine, 4(8). https://doi.org/10.1002/jhm.527

Body mass index (BMI) and risk of noncardiac postoperative medical complications in elderly hip fracture patients : A population-based study. / Batsis, John A.; Huddleston, Jeanne M.; Melton, L. Joseph; Huddleston, Paul M.; Larson, Dirk R.; Gullerud, Rachel E.; McMahon, M. Molly.

In: Journal of Hospital Medicine, Vol. 4, No. 8, 10.2009.

Research output: Contribution to journalArticle

Batsis, John A. ; Huddleston, Jeanne M. ; Melton, L. Joseph ; Huddleston, Paul M. ; Larson, Dirk R. ; Gullerud, Rachel E. ; McMahon, M. Molly. / Body mass index (BMI) and risk of noncardiac postoperative medical complications in elderly hip fracture patients : A population-based study. In: Journal of Hospital Medicine. 2009 ; Vol. 4, No. 8.
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abstract = "BACKGROUND: Obese patients are thought to be at higher risk of postoperative medical complications. We determined whether body mass index (BMI) is associated with postoperative in-hospital noncardiac complications following urgent hip fracture repair. METHODS: We conducted a population-based study of Olmsted County, Minnesota, residents operated on for hip fracture in 1988 to 2002. BMI was categorized as underweight (<18.5 kg/m2), normal (18.5-24.9 kg/m2), overweight (25.0-29.9 kg/m2), and obese (≥30 kg/m2). Postoperative inpatient noncardiac medical complications were assessed. Complication rates were estimated for each BMI category and overall rates were assessed using logistic regression modeling. RESULTS: There were 184 (15.6{\%}) underweight, 640 (54.2{\%}) normal, 251 (21.3{\%}) overweight, and 105 (8.9{\%}) obese hip fracture repairs (mean age, 84.2 ± 7.5 years; 80{\%} female). After adjustment, the risk of developing an inpatient noncardiac complication for each BMI category, compared to normal BMI, was: underweight (odds ratio [OR], 1.33; 95{\%} confidence interval [CI], 0.95-1.88; P = 0.10), overweight (OR, 1.01; 95{\%} CI, 0.74-1.38; P = 0.95), and obese (OR, 1.28; 95{\%} CI, 0.82-1.98; P = 0.27). Multivariate analysis demonstrated that an ASA status of III-V vs. I-II (OR, 1.84; 95{\%} CI, 1.25-2.71; P = 0.002), a history of chronic obstructive pulmonary disease (COPD) or asthma (OR, 1.58; 95{\%} CI, 1.18-2.12; P = 0.002), male sex (OR, 1.49; 95{\%} CI, 1.10-2.02; P = 0.01), and older age (OR, 1.05; 95{\%} CI, 1.03-1.06; P < 0.001) contributed to an increased risk of developing a postoperative noncardiac inpatient complication. Underweight patients had higher in-hospital mortality rates than normal BMI patients (9.3 vs. 4.4{\%}; P = 0.01). CONCLUSIONS: BMI has no significant influence on postoperative noncardiac medical complications in hip-fracture patients. These results attenuate concerns that obese or frail, underweight hip-fracture patients may be at higher risk postoperatively for inpatient complications.",
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AU - Melton, L. Joseph

AU - Huddleston, Paul M.

AU - Larson, Dirk R.

AU - Gullerud, Rachel E.

AU - McMahon, M. Molly

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N2 - BACKGROUND: Obese patients are thought to be at higher risk of postoperative medical complications. We determined whether body mass index (BMI) is associated with postoperative in-hospital noncardiac complications following urgent hip fracture repair. METHODS: We conducted a population-based study of Olmsted County, Minnesota, residents operated on for hip fracture in 1988 to 2002. BMI was categorized as underweight (<18.5 kg/m2), normal (18.5-24.9 kg/m2), overweight (25.0-29.9 kg/m2), and obese (≥30 kg/m2). Postoperative inpatient noncardiac medical complications were assessed. Complication rates were estimated for each BMI category and overall rates were assessed using logistic regression modeling. RESULTS: There were 184 (15.6%) underweight, 640 (54.2%) normal, 251 (21.3%) overweight, and 105 (8.9%) obese hip fracture repairs (mean age, 84.2 ± 7.5 years; 80% female). After adjustment, the risk of developing an inpatient noncardiac complication for each BMI category, compared to normal BMI, was: underweight (odds ratio [OR], 1.33; 95% confidence interval [CI], 0.95-1.88; P = 0.10), overweight (OR, 1.01; 95% CI, 0.74-1.38; P = 0.95), and obese (OR, 1.28; 95% CI, 0.82-1.98; P = 0.27). Multivariate analysis demonstrated that an ASA status of III-V vs. I-II (OR, 1.84; 95% CI, 1.25-2.71; P = 0.002), a history of chronic obstructive pulmonary disease (COPD) or asthma (OR, 1.58; 95% CI, 1.18-2.12; P = 0.002), male sex (OR, 1.49; 95% CI, 1.10-2.02; P = 0.01), and older age (OR, 1.05; 95% CI, 1.03-1.06; P < 0.001) contributed to an increased risk of developing a postoperative noncardiac inpatient complication. Underweight patients had higher in-hospital mortality rates than normal BMI patients (9.3 vs. 4.4%; P = 0.01). CONCLUSIONS: BMI has no significant influence on postoperative noncardiac medical complications in hip-fracture patients. These results attenuate concerns that obese or frail, underweight hip-fracture patients may be at higher risk postoperatively for inpatient complications.

AB - BACKGROUND: Obese patients are thought to be at higher risk of postoperative medical complications. We determined whether body mass index (BMI) is associated with postoperative in-hospital noncardiac complications following urgent hip fracture repair. METHODS: We conducted a population-based study of Olmsted County, Minnesota, residents operated on for hip fracture in 1988 to 2002. BMI was categorized as underweight (<18.5 kg/m2), normal (18.5-24.9 kg/m2), overweight (25.0-29.9 kg/m2), and obese (≥30 kg/m2). Postoperative inpatient noncardiac medical complications were assessed. Complication rates were estimated for each BMI category and overall rates were assessed using logistic regression modeling. RESULTS: There were 184 (15.6%) underweight, 640 (54.2%) normal, 251 (21.3%) overweight, and 105 (8.9%) obese hip fracture repairs (mean age, 84.2 ± 7.5 years; 80% female). After adjustment, the risk of developing an inpatient noncardiac complication for each BMI category, compared to normal BMI, was: underweight (odds ratio [OR], 1.33; 95% confidence interval [CI], 0.95-1.88; P = 0.10), overweight (OR, 1.01; 95% CI, 0.74-1.38; P = 0.95), and obese (OR, 1.28; 95% CI, 0.82-1.98; P = 0.27). Multivariate analysis demonstrated that an ASA status of III-V vs. I-II (OR, 1.84; 95% CI, 1.25-2.71; P = 0.002), a history of chronic obstructive pulmonary disease (COPD) or asthma (OR, 1.58; 95% CI, 1.18-2.12; P = 0.002), male sex (OR, 1.49; 95% CI, 1.10-2.02; P = 0.01), and older age (OR, 1.05; 95% CI, 1.03-1.06; P < 0.001) contributed to an increased risk of developing a postoperative noncardiac inpatient complication. Underweight patients had higher in-hospital mortality rates than normal BMI patients (9.3 vs. 4.4%; P = 0.01). CONCLUSIONS: BMI has no significant influence on postoperative noncardiac medical complications in hip-fracture patients. These results attenuate concerns that obese or frail, underweight hip-fracture patients may be at higher risk postoperatively for inpatient complications.

KW - Elderly

KW - Hip fractures

KW - Inpatient

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KW - Obesity

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