Outcome Analysis of Obesity in Trauma Surgery Related to Closed Injuries of Lower Limb in Orthopedic Surgery

Background: Obesity is fast becoming a global epidemic and has profound effect on lower limb trauma surgeries is not well defined. This study aimed to evaluate and investigate the influence of obesity on health related quality of life (HRQL), patient reported outcome, incidence of postoperative surgical site infection (SSI), perioperative and postoperative complications. The specific association of obesity and outcome is not examined and measured previously in trauma surgery of lower limbs. Methods and Materials: During 2005 to 2014, a total of 12853 patients underwent different lower limb trauma surgeries and outcome measurement was based according to Body Mass Index (BMI). 10885 Patients with BMI of < 30kg/m2 were classified as non-obese and used as control groups. 1968 Patients with BMI of ≥ 30 kg/m2 were classified as obese and data analyzed in terms of outcome, adverse effects, complications and health related quality of life (HRQL) Results: The Increase in BMI leads to increased perioperative complications in terms of Intubation difficulty, blood loss, and duration of surgery. The post-operative adverse incidences in early period like deep venous thrombosis (DVT), surgical site infections (SSI), cardiac and renal events, superficial and deep infections were significant statistically. The delayed adverse effects relate to complications like late development of surgical site infection (SSI), implant loosening and orthopedic implant failure, re-operation rates for different complications. The improvement in health related quality (HQRL) is low among obese patients. Conclusions: Obesity has an inverse influence on patient outcome as compared to non obese patients. However, despite these increased obese patients do benefit from trauma surgeries of lower limb and patient reported outcome was found to be slightly lower among obese patients