The safety and efficacy of outpatient total hip arthroplasty in very obese patients
Notice bibliographique
Résumé
Aims As the number of patients who undergo total joint replacement as an outpatient continues to increase, it is essential that the safety and efficacy of this form of treatment is maintained. The aim of this study was to examine the outcome in a series of very obese patients who underwent total hip arthroplasty (THA) as an outpatient. Methods A prospective database was used to identify 381 patients who underwent THA as an outpatient. Using case-control matching based on age, sex, and American Society of Anesthesiologists grade, 51 very obese patients with a BMI > 35 kg/m 2 were matched to 51 patients with a BMI < 35 kg/m 2 who underwent THA as an outpatient. In a subsequent analysis, 47 patients (41 THAs) from the same very obese cohort were matched to 47 very obese patients who underwent THA as an inpatient. For each group, readmission within 90 days, return to the emergency department (ED) within 90 days, adverse events, and reoperations were recorded. Results The mean BMI of the very obese outpatient group was 40 kg/m 2 (35 to 55); their mean age was 61 years (38 to 78). The mean BMI of the outpatients with a BMI < 35 kg/m 2 was 27 kg/m 2 (17 to 34); their mean age was 61 years (33 to 78). The mean BMI of the very obese inpatient group was 40 kg/m 2 (35 to 55); their mean age 62 years (34 to 77). Between the two outpatient groups, the rate of adverse events was significantly higher in the very obese group (15.69% compared with 1.96% (p = 0.015)). The reoperation rate was also significantly higher in the very obese group (five cases compared with none; p = 0.022). The rate of readmission and return to the ED within 90 days did not differ significantly between the groups (p = 0.299 and p = 0.092, respectively). There was no significant difference for all outcomes between the very obese patients who were treated as an outpatient and those who were treated as an inpatient. Conclusion The very obese group had significantly higher rates of adverse events and reoperations compared with those with a BMI < 35 kg/m 2 , but there was no difference when they were compared with a matched cohort of very obese patients who were treated as an inpatient. Caution must always be taken to identify the ideal candidates for outpatient surgery. However, BMI should not be used as a sole variable for deciding whether THA should be undertaken as an inpatient. Cite this article: Bone Joint J 2025;107-B(5 Supple A):3–8.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».