Body mass index and risk of perioperative cardiovascular adverse events and mortality in 34,744 Danish patients undergoing hip or knee replacement.
Background and purpose - Obesity is a risk factor for osteoarthritis in the lower limb, yet the cardiovascular risks associated with obesity in hip or knee replacement surgery are unknown. We examined associations between body mass index (BMI) and the risk of a major adverse cardiovascular event (MA...
| Publicado en: | Acta Orthopaedica Vol. 85; no. 5; pp. 456 - 463 |
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| Autores principales: | , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Medical Journals Sweden AB
Sep2014
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=103897204&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 103897204 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 17453674 1BVL jtl: Acta Orthopaedica issn: 17453674 maglogo: N pubinfo: dt: Sep2014 vid: 85 iid: 5 pid: 59195 pub: Medical Journals Sweden AB artinfo: ui: 103897204 98580564 10.3109/17453674.2014.934184 NLM24954493 103897204 ppf: 456 ppct: 7 formats: fmt: @attributes: type: P tig: atl: Body mass index and risk of perioperative cardiovascular adverse events and mortality in 34,744 Danish patients undergoing hip or knee replacement. aug: au: Thornqvist, Catharina Gislason, Gunnar H Køber, Lars Jensen, Per Føge Torp-Pedersen, Christian Andersson, Charlotte affil: Department of Orthopedic Surgery, Aabenraa Hospital sug: subj: Body Mass Index Intraoperative Complications Risk Factors Arthroplasty, Replacement, Hip Mortality Arthroplasty, Replacement, Knee Mortality Cardiovascular Diseases Complications Treatment Outcomes Denmark Confidence Intervals Cox Proportional Hazards Model Linear Regression Human Male Female Aged Aged, 80 and Over Middle Age Descriptive Statistics Data Analysis Software Sensitivity and Specificity Aged: 65+ years Aged, 80 & over Middle Aged: 45-64 years Male Female ab: Background and purpose - Obesity is a risk factor for osteoarthritis in the lower limb, yet the cardiovascular risks associated with obesity in hip or knee replacement surgery are unknown. We examined associations between body mass index (BMI) and the risk of a major adverse cardiovascular event (MACE: ischemic stroke, acute myocardial infarction, or cardiovascular death) or the risk of all-cause mortality in a nationwide Danish cohort of patients who underwent primary hip or knee replacement surgery. Methods - Using Danish nationwide registries, we identified 34,744 patients aged ≥ 20 years who underwent elective primary hip or knee replacement surgery between 2005 and 2011. We used multivariable Cox regression models to calculate the 30-day risks of MACE and mortality associated with 5 BMI groups (underweight (BMI < 18.5 kg/m2), normal weight (18.5-24 kg/m2), overweight (25-29 kg/m2), obese 1 (30-34 kg/m2), and obese 2 (≥ 35 kg/m2)). Results - In total, 232 patients (0.7%) had a MACE and 111 (0.3%) died. Compared with overweight, adjusted hazard ratios (HRs) were 1.2 (95% CI: 0.4-3.3), 1.3 (0.95-1.8), 1.6 (1.1-2.2), and 1.0 (0.6-1.9) for underweight, normal weight, obese 1, and obese 2 regarding MACE. Regarding mortality, the corresponding HRs were 7.0 (2.8-15), 2.0 (1.2-3.2), 1.5 (0.9-2.7), and 1.9 (0.9-4.2). Cubic splines suggested a significant U-shaped relationship between BMI and risks with nadir around 27-28. Interpretation - In an unselected cohort of patients undergoing elective primary hip or knee replacement surgery, U-shaped risks of perioperative MACE and mortality were found in relation to BMI. Patients within the extreme ranges of BMI may warrant further attention. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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