90 Day Costs, Reoperations, and Readmissions for Primary Total Hip Arthroplasty Patients of Varying BMI Levels

Abstract Background The purpose of this study is to compare 90-day costs and outcomes for primary total hip arthroplasty (THA) patients between a non-obese (BMI 18.5-24.9) versus overweight (25-29.9), obese (30-34.9), severely-obese (35-39.9), morbidly-obese (40-44.9), and super-obese (45+) cohorts. Methods We conducted a retrospective review of an institutional database of primary THA patients from 2006-2013. Thirty-three super-obese patients were identified, and the other five cohorts were randomly selected in a 2:1 ratio (n=363). Demographics, 90-day outcomes (costs, reoperations, and readmissions), and outcomes after three years (revisions and change scores for SF12, HHS, and WOMAC) were collected. Costs were determined using unit costs from our institutional administrative data for all in-hospital resource utilization. Comparisons between the non-obese and other groups were made with Kruskal-Wallis tests for non-normal data and chi-square and Fisher's exact test for categorical data. Results The 90-day costs in the morbidly-obese ($13,134±7,250 mean±standard deviation, p Conclusion Super-obese patients have greater risks and costs compared to non-obese patients, but also have comparable quality of life improvements.