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Shoulder arthroplasty more costly in morbidly obese patients
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Hospital costs, comorbidity rate and discharge destination are the primary differences in performing shoulder arthroplasty on morbidly obese patients, study results show.
Researchers compared 21 patients with a body mass index (BMI) of 40 kg/m2 or greater who underwent primary reverse shoulder arthroplasty not related to fracture between 2003 and 2010 with 63 control patients with a BMI less than 30 kg/m2. Mean follow-up was 45 months and 48 months, respectively.
The researchers analyzed patients’ Charlson-Deyo comorbidity index (CDI) score, total comorbidities, operative time, blood loss, duration of hospital stay, discharge disposition, costs and complications.
Average hospital costs were $2,974 higher for morbidly obese patients. These patients were also six times more likely to be discharged to a rehab facility rather than their home, according to the researchers. Morbidly obese patients also had longer operative times by about 13 minutes, and 40 mL greater blood loss than non-obese patients.
Upon discharge, morbidly obese patients exhibited more total comorbidities (excluding obesity) than non-obese patients (six to four, respectively) as well as higher CDI (two to one, respectively) and higher rate of obstructive sleep apnea.
Both non-obese and morbidly obese had similar changes in American Shoulder and Elbow Surgeons scores in function (32 preoperatively to 69 at final follow-up and 40 to 78, respectively) and forward flexion (61° to 140° and 74° to 153°, respectively).
Disclosure: See the study for a full list of all authors’ relevant financial disclosures.
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