Achilles Tendon Repair in Obese Patients Is Associated With Increased Complication Rates. Issue 3 (June 2016)

• Record Type: Journal Article
• Authors: Burrus, M. Tyrrell; Werner, Brian C.; Park, Joseph S.; Perumal, Venkat; Cooper, M. Truit
• Is Part Of: Foot & ankle specialist. Volume 9:Issue 3(2016:Jun.)
• Page Start: 208
• Page End: 214
• Publication Date: 2016-06
• Subjects: obesity -- primary Achilles tendon repair -- complications -- wound complications -- infection; Podiatry -- Periodicals; Orthopedics -- Periodicals; Foot -- Diseases -- Periodicals; Foot -- Surgery -- Periodicals; Ankle -- Surgery -- Periodicals; 617.585
• DOI: 10.1177/1938640015609983
• Languages: English
• ISSNs: 1938-6400

Abstract

Objective . The objective of the present study is to utilize a national database to examine the association between obesity and postoperative complications after primary Achilles tendon repair. Methods . The PearlDiver database was queried for patients undergoing primary Achilles repair using CPT 27650. Excision of a Haglund's deformity or tendon transfer were exclusion criteria. Patients were then divided into obese (body mass index [BMI] > 30 kg/m 2 ) and nonobese (BMI < 30 kg/m 2 ) cohorts using ICD-9 codes. Complications within 90 days postoperatively were assessed using ICD-9 and CPT codes. Results . In all, 18 948 patients who underwent primary Achilles tendon repair were identified from 2005 to 2012. Overall, 2962 patients (15.6%) were coded as obese or morbidly obese. Obese patients had significantly higher rates of postoperative wound complications (odds ratio [OR] = 2.1; P < .0001), infection (OR = 1.8; P < .0001), venous thromboembolism (VTE; OR = 1.8; P = .001), and medical complications (OR = 3.9; P < .0001) compared with nonobese patients after primary Achilles tendon repair. Additionally, obese patients had a significantly lower rate of ankle stiffnesassociated with a significantly higher risk of s (OR = 0.4; P < .0001) compared with nonobese patients. Conclusion . Obesity is associated with a significantly higher risk of wound complications, infection, VTE, and medical complications after primary Achilles tendon repair. Levels of Evidence: Prognostic, Level II: Retrospective study