【罂粟摘要】日间关节镜检查后体重指数与当天入院、术后并发症以及30天再入院的关系
日间关节镜检查后体重指数与当天入院、术后并发症以及30天再入院的关系
我们研究日间关节镜检查后，体重指数（BMI）与入院、当日并发症以及30天再入院的相关性。
回顾性队列研究。
多机构参与。
在门诊接受膝关节、髋关节或肩关节镜检查的成年患者。
无。
使用美国外科医师学会国家外科质量改进计划2012~2016年的数据集，我们研究了7个BMI范围：正常BMI（≥20 kg/m2和<25 kg/m2）、体重不足（<20 kg/m2）、超重（≥25 kg/m2和<30 kg/m2）、1级和2级肥胖（≥30 kg/m2和<40 kg/m2，参考变量），重度肥胖，我们将其划分为≥40kg/m2和<50kg/m2，≥50kg/m2，<60kg/m2，≥60kg/m2。主要结果是日间入院率。次要结果包括当天的术后并发症和30天再入院率。我们进行了多变量逻辑回归，报告了优势比（OR）及其相关的95%可信区间（CI），认为p值<0.05具有统计学意义。
共有99410例患者纳入最终分析，住院率为2.6%。与3级肥胖相比，只有BMI≥50kg/m2（OR：1.55, 95%CI：1.18–2.01, p=0.005）的患者入院率增加。30天再次入院和术后当天并发症的发生率无差异。
我们发现，只有BMI≥50kg/m2的患者即使在共存疾病得到改善的情况下，当天入院的几率也会增加，提示BMI≥50kg/m2可作为关节镜检查选择患者的唯一因素。对于BMI<50 kg/m2的患者，我们建议不应单独使用BMI来排除在门诊进行关节镜检查的患者，尤其是考虑到该患者群体在关节镜检查中占很大比例。
The association of body mass index with same-day hospital admission, postoperative complications, and 30-day readmission following day-case eligible joint arthroscopy: A national registry analysis
ABSTRACT
Study objective: We examined the association of body mass index (BMI) with hospital admission, same-day complications, and 30-day hospital readmission following day-case eligible joint arthroscopy.
Design: Retrospective cohort study.
Setting: Multi-institutional.
Patients: Adult patients undergoing arthroscopy of the knee, hip or shoulder in the outpatient setting.
Intervention: None.
Measurements: Using the American College of Surgeons National Surgical Quality Improvement Program dataset from 2012 to 2016, we examined seven BMI ranges: normal BMI (≥20 kg/m2 and < 25 kg/m2 ), underweight (< 20 kg/m2 ), overweight (≥25 kg/m2 and < 30 kg/m2 ), Class 1 and 2 obese (≥30 kg/m2 and < 40 kg/m2, reference variable), and severe obesity, which we divided into the following BMI ranges: ≥40 kg/m2 and < 50 kg/m2, ≥50 kg/m2 and < 60 kg/m2 , and ≥60 kg/m2. The primary outcome was hospital admission. Secondary outcomes included same-day postoperative complications and 30-day hospital readmission. We performed multivariable logistic regression and reported odds ratios (OR) and their associated 95% confidence interval (CI) and considered a p-value of < 0.05 as statistically significant.
Main results: There were a total of 99,410 patients included in the final analysis, in which there was a 2.6% rate of hospital admission. When compared to class 3 obesity, only those with BMI ≥50 kg/m2 (OR 1.55, 95% CI 1.18–2.01, p = 0.005) had increased odds of hospital admission. There were no differences in 30-day hospital readmission or same-day postoperative complications.
Conclusion: We found that only patients with BMI ≥50 kg/m2 had increased odds for same-day hospital admission even when patient's comorbid conditions are optimized, suggesting that a BMI ≥50 kg/m2 may be used as a sole factor for patient selection in patients undergoing joint arthroscopy. For patients with BMI < 50 kg/m2, we recommend that BMI alone should not be solely used to exclude patients from having joint arthroscopies performed in an outpatient setting, especially since this patient group makes up a significant proportion of joint arthroscopy.
翻译：冯玉蓉 | 编辑：佟睿 | 审核：曹莹