Perioperative medicine & outcomes
Relationships Between Body Mass Index, Allogeneic Transfusion, and Surgical Site Infection After Knee and Hip Arthroplasty Surgery
Authors' conclusion
SSI incidence remained unchanged despite continuous reductions in blood transfusion in TKA and THA patients over 8 years. In TKA, ORs for SSI increased, but ORs for transfusion decreased with increasing BMI above normal. Conversely, in THA, ORs for SSI and transfusion both increased for a BMI 40+, but only OR for transfusion increased in underweight patients.
Study context
- Population
- TKA and THA cases, National Surgical Quality Improvement Program database, 2011–2018333,223 TKA and 41,157 THA cases
- Exposure
- Body mass index (BMI) categories vs normal BMI
- Outcome
- SSI (OR vs normal BMI, adjusted for potential confounders)
Methodological detailsregistry database (NSQIP), multivariable regression
- Registry database (NSQIP)
- Multivariable regression
Main finding
As reported in the abstract
SSI
BMI 40+ vs Normal BMIOdds ratio (95% CI)
TKA; only BMI 40+ associated with higher OR
1.86(1.60–2.18)
THA; increased ORs for all BMI levels above normal, highest for BMI 40+
3.08(2.47–3.83)
Observational data: associations, not effects.
Further findings
| Outcome | OR (95% CI) | |
|---|---|---|
| Perioperative transfusionBMI 40+ vs Normal BMI · TKA; ORs decreased with increasing BMI | 0.51 (0.47–0.54) | |
| Perioperative transfusionBMI 40+ vs Normal BMI · THA; ORs began to increase slightly in overweight patients | 1.36 (1.21–1.54) | |
| 0.512Odds ratio (log scale) |
Perioperative transfusion
- Perioperative transfusion decreased significantly over time for both TKA and THA
Original publication
Relationships Between Body Mass Index, Allogeneic Transfusion, and Surgical Site Infection After Knee and Hip Arthroplasty Surgery. Anesth Analg. Published 7 April 2022. doi:10.
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