Body Mass Index and the Impact on Hospital Resource Use in Patients Undergoing Total Knee Arthroplasty

Journal of Arthroplasty

Volumn 25, Issue 8, 2010, Pages

  Batsis, John A ^a   Naessens, James M ^b   Keegan, Mark T ^b   Huddleston, Paul M ^b   Wagie, Amy E ^b   Huddleston, Jeanne M ^b  

^a DARTMOUTH HITCHCOCK MEDICAL CENTER   (United States)

^b MAYO CLINIC   (United States)

Author keywords

Arthroplasty; Body mass index; Costs; Length of stay; Resource use

Indexed keywords

ADULT; AGED; ARTICLE; BODY MASS; FEMALE; HEALTH CARE COST; HEALTH CARE UTILIZATION; HUMAN; LENGTH OF STAY; MAJOR CLINICAL STUDY; MALE; MORBID OBESITY; PREOPERATIVE EVALUATION; TOTAL KNEE REPLACEMENT;

EID: 78249285292     PISSN: 08835403     EISSN: None     Source Type: Journal    
DOI: 10.1016/j.arth.2009.09.009     Document Type: Article

References (38)

1. Heinegard D., Johnell O., Lidgren L., et al. The Bone and Joint Decade 2000-2010. Acta Orthop Scand 1998, 69:219.
2. Katz B.P., Freund D.A., Heck D.A., et al. Demographic variation in the rate of knee replacement: a multi-year analysis. Health Serv Res 1996, 31:125.
3. HCUPnet Healthcare Costs and Utilization Project. Agency for Healthcare Research and Quality 2002, Available at, Accessed January 25, 2005. http://www.ahrq.gov.
4. National and state medical expenditures and lost earnings attributable to arthritis and other rheumatic conditions-United States, 2003. MMWR Morb Mortal Wkly Rep 2007, 56(1):4.
5. Gabriel S.E., Crowson C.S., O'Fallon W.M. Costs of osteoarthritis: estimates from a geographically defined population. J Rheumatol Suppl 1995, 43:23.
6. Madhok R., Lewallen D.G., Wallrichs S.L., et al. Trends in the utilization of primary total hip arthroplasty, 1969 through 1990: a population-based study in Olmsted County. Minnesota. Mayo Clin Proc 1993, 68:11.
7. Batsis J.A., Naessens J.M., Keegan M.T., et al. Cost-savings of hip arthroplasty patients on specialty orthopedic surgery units. Am J Orthop 2009, 38:E5.
8. Batsis J.A., Naessens J.M., Keegan M.T., et al. Resource utilization of total knee arthroplasty patients cared for on specialty orthopedic surgery units. J Hosp Med 2008, 3:218.
9. Finkelstein E.A., Fiebelkorn I.C., Wang G. State-level estimates of annual medical expenditures attributable to obesity. Obes Res 2004, 12:18.
10. Quesenberry C.P., Caan B., Jacobson A. Obesity, health services use, and health care costs among members of a health maintenance organization. Arch Intern Med 1998, 158:466.
11. Wolf A.M., Colditz G.A. Current estimates of the economic cost of obesity in the United States. Obes Res 1998, 6:97.
12. Epstein A.M., Read J.L., Hoefer M. The relation of body weight to length of stay and charges for hospital services for patients undergoing elective surgery: a study of two procedures. Am J Public Health 1987, 77:993.
13. Jibodh S.R., Gurkan I., Wenz J.F. In-hospital outcome and resource use in hip arthroplasty: influence of body mass. Orthopedics 2004, 27:594.
14. Berry D.J., Kessler M., Morrey B.F. Maintaining a hip registry for 25 years. Mayo Clinic experience. Clin Orthop Relat Res 1997, 61.
15. Charlson M., Szatrowski T.P., Peterson J., et al. Validation of a combined comorbidity index. J Clin Epidemiol 1994, 47:1245.
16. Blanchette C.M., Wang P.F., Joshi A.V., et al. Resource utilization and costs of blood management services associated with knee and hip surgeries in US hospitals. Adv Ther 2006, 23:54.
17. Rorabeck C.H., Murray P. The cost benefit of total knee arthroplasty. Orthopedics 1996, 19:777.
18. Zizza C., Herring A.H., Stevens J., et al. Length of hospital stays among obese individuals. Am J Public Health 2004, 94:1587.
19. Thompson D., Brown J.B., Nichols G.A., et al. Body mass index and future healthcare costs: a retrospective cohort study. Obes Res 2001, 9:210.
20. Bozic K.J., Katz P., Cisternas M., et al. Hospital resource utilization for primary and revision total hip arthroplasty. J Bone Joint Surg Am 2005, 87:570.
21. Prasad N., Padmanabhan V., Mullaji A. Blood loss in total knee arthroplasty: an analysis of risk factors. Int Orthop 2007, 31:39.
22. Mylod A.G., France M.P., Muser D.E., et al. Perioperative blood loss associated with total knee arthroplasty. A comparison of procedures performed with and without cementing. J Bone Joint Surg Am 1990, 72:1010.
23. Ray D.E., Matchett S.C., Baker K., et al. The effect of body mass index on patient outcomes in a medical ICU. Chest 2005, 127:2125.
24. Finkielman J.D., Gajic O., Afessa B. Underweight is independently associated with mortality in post-operative and non-operative patients admitted to the intensive care unit: a retrospective study. BMC Emerg Med 2004, 4:3.
25. Maurer M.S., Luchsinger J.A., Wellner R., et al. The effect of body mass index on complications from cardiac surgery in the oldest old. J Am Geriatr Soc 2002, 50:988.
26. Reeves B.C., Ascione R., Chamberlain M.H., et al. Effect of body mass index on early outcomes in patients undergoing coronary artery bypass surgery. J Am Coll Cardiol 2003, 42:668.
27. Fleisher L.A., Beckman J.A., Brown K.A., et al. ACC/AHA 2007 Guidelines on Perioperative Cardiovascular Evaluation and Care for Noncardiac Surgery. A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 2002 Guidelines on Perioperative Cardiovascular Evaluation for Noncardiac Surgery). Circulation 2007, e418.
28. SooHoo N.F., Lieberman J.R., Ko C.Y., et al. Factors predicting complication rates following total knee replacement. J Bone Joint Surg Am 2006, 88:480.
29. Dixon J., Sanderson C., Elliott P., et al. Assessment of the reproducibility of clinical coding in routinely collected hospital activity data: a study in two hospitals. J Public Health Med 1998, 20:63.
30. Huddleston J.M., Long K.H., Naessens J.M., et al. Medical and surgical comanagement after elective hip and knee arthroplasty: a randomized, controlled trial. Ann Intern Med 2004, 141:28.
31. Melton L.J. History of the Rochester Epidemiology Project. Mayo Clin Proc 1996, 71:266.
32. Jiganti J.J., Goldstein W.M., Williams C.S. A comparison of the perioperative morbidity in total joint arthroplasty in the obese and nonobese patient. Clin Orthop Relat Res 1993, 175.
33. Marzetti E., Leeuwenburgh C. Skeletal muscle apoptosis, sarcopenia and frailty at old age. Exp Gerontol 2006, 41:1234.
34. Gallagher D., Visser M., Sepulveda D., et al. How useful is body mass index for comparison of body fatness across age, sex, and ethnic groups?. Am J Epidemiol 1996, 143:228.
35. Romero-Corral A., Somers V.K., Sierra-Johnson J., et al. Accuracy of body mass index in diagnosing obesity in the adult general population. Int J Obes (Lond) 2008, 32:959.
36. Andreyeva T., Sturm R., Ringel J.S. Moderate and severe obesity have large differences in health care costs. Obes Res 2004, 12:1936.
37. Leon-Munoz L.M., Guallar-Castillon P., Lopez Garcia E., et al. Relationship of BMI, waist circumference, and weight change with use of health services by older adults. Obes Res 2005, 13:1398.
38. Vincent H.K., Weng J.P., Vincent K.R. Effect of obesity on inpatient rehabilitation outcomes after total hip arthroplasty. Obesity (Silver Spring) 2007, 15:522.