title: Effect of obesity on inpatient rehabilitation outcomes after total hip arthroplasty.
abstract: OBJECTIVE
  This study examined whether obesity affected inpatient rehabilitation outcomes after total hip arthroplasty (THA).
  
  
  METHODS
  This was a retrospective, comparative study conducted using a computerized medical database derived from THA patients at a university-affiliated rehabilitation hospital (data from 2002 to 2005). Patients were divided into four brackets based on BMI: non-obese (<25 kg/m(2)), overweight (25 to 29.9 kg/m(2)), moderate obesity (30 to 39.9 kg/m(2)), and severe obesity (> or = 40 kg/m(2)). All patients completed an interdisciplinary inpatient rehabilitation program after THA. Functional independence measure (FIM) scores, length of stay (LOS), FIM efficiency scores (FIM/LOS), hospital charges, and discharge disposition location were collected.
  
  
  RESULTS
  FIM scores improved from admission to discharge similarly in all groups (25 to 29.5 points). However, FIM efficiency, LOS, and total charges were curvilinearly related with BMI (all p < 0.05). Total hospital charges were highest in the severely obese group compared with the overweight group (p < 0.05). Non-homebound discharge disposition rates were lower in non-obese (13.1%) and severely obese groups (10.5%).
  
  
  CONCLUSIONS
  Elevated BMI does not prevent FIM gains in THA patients during inpatient rehabilitation. However, BMI is related with FIM efficiency, LOS, and hospital charges in a curvilinear fashion. Severely obese patients can achieve physical improvements but at a lower efficiency and greater cost.
authors.affiliation: Department of Orthopedics and Rehabilitation, University of Florida, Gainesville, FL 32611, USA. hkvincent@comcast.net
authors.forename: Heather K
authors.initials: HK
authors.lastname: Vincent
authors.forename: Jenpin P
authors.initials: JP
authors.lastname: Weng
authors.forename: Kevin R
authors.initials: KR
authors.lastname: Vincent
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000191:economics / Q000534:rehabilitation*; D015992:Body Mass Index; D005260:Female; D006801:Humans; D007297:Inpatients; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications* / Q000191:economics; D017063:Outcome Assessment, Health Care; D010351:Patient Discharge; D012047:Rehabilitation Centers / Q000191:economics; D012189:Retrospective Studies