Obesity Raises Risk of Complications With Pelvic, Acetabular Fractures

Doctors have long been lecturing (and warning) patients about the health hazards of obesity. Too much extra weight, they insist, takes a toll on the heart.

It also apparently takes a toll on bones, too. A new study has tied both obesity and morbid obesity with an increase in complications after surgery for acetabular and pelvic fractures.

Researchers from Vanderbilt University Medical Center and Vanderbilt University School of Medicine in Nashville, Tenn., retrospectively collected data of 95 patients with isolated pelvic fractures, 118 with isolated acetabular fractures and 31 patients had a combination of both fracture types. The collection spanned five years.

Clinicians found the patients in the Trauma Registry of the American College of Surgeons data base. The collected data included demographics, Injury Severity Score, mechanical ventilation duration, hospital length of stay, and complications.

Initial trauma admission history and physical examinations also were used to calculate body mass index (BMI). In-hospital complications were the primary outcome variable. The rate of operative complications were determined with subgroup analysis of patients who underwent treatment for pelvic or acetabular fractures.

Results showed the mean Injury severity score was 12.8 with motor vehicle collisions as the most common injury mechanism, followed by falls from heights greater than standing and other. Average BMI was 27.4 kg/m². No difference was observed between nonobese patients and obese patients with regard to operative interventions.  Patients with a BMI of 30 kg/m² or more compared with nonobese patients had a significantly longer length of hospital stay, the study concluded.

Nineteen patients developed complications. Complication rates were statistically significant among patients with a BMI of 30 kg/m², 30 to 39 kg/m², 40 kg/m² or greater but complication rates were not significantly different in fractures treated surgically compared with those not treated surgically. According to the multivariable logistic regression model, a significant independent risk factor for complications after an injury was obesity when adjusted to age and the Injury Severity Score. Obese patients had a significantly greater rate of complications compared with patients who were not obese, according to subgroup analysis.