title: Obesity increases operating room times in patients undergoing primary hip arthroplasty: a retrospective cohort analysis.
abstract: Background. Obesity impacts utilization of healthcare resources. The goal of this study was to measure the relationship between increasing body mass index (BMI) in patients undergoing total hip arthroplasty (THA) with different components of operating room (OR) time. Methods. The Stanford Translational Research Integrated Database Environment (STRIDE) was utilized to identify all ASA PS 2 or 3 patients who underwent primary THA at Stanford Medical Center from February 1, 2008 through January 1, 2013. Patients were divided into five groups based on the BMI weight classification. Regression analysis was used to quantify relationships between BMI and the different components of total OR time. Results. 1,332 patients were included in the study. There were no statistically significant differences in age, gender, height, and ASA PS classification between the BMI groups. Normal-weight patients had a total OR time of 138.9 min compared 167.9 min (P < 0.001) for morbidly obese patients. At a BMI > 35 kg/m(2) each incremental BMI unit increase was associated with greater incremental total OR time increases. Conclusion. Morbidly obese patients required significantly more total OR time than normal-weight patients undergoing a THA procedure. This increase in time is relevant when scheduling obese patients for surgery and has an important impact on health resource utilization.
authors.affiliation: Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University Medical Center , Stanford, CA , USA.
authors.forename: Bassam
authors.initials: B
authors.lastname: Kadry
authors.affiliation: Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University Medical Center , Stanford, CA , USA.
authors.forename: Christopher D
authors.initials: CD
authors.lastname: Press
authors.affiliation: Department of Orthopaedic Surgery, Hospital of the University of Pennsylvania , Silverstein, Philadelphia, PA , USA.
authors.forename: Hassan
authors.initials: H
authors.lastname: Alosh
authors.affiliation: Stanford University Economics Department , Stanford, CA , USA.
authors.forename: Isaac M
authors.initials: IM
authors.lastname: Opper
authors.affiliation: Stanford University Economics Department , Stanford, CA , USA.
authors.forename: Joe
authors.initials: J
authors.lastname: Orsini
authors.affiliation: Stanford University Economics Department , Stanford, CA , USA.
authors.forename: Igor A
authors.initials: IA
authors.lastname: Popov
authors.affiliation: Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University Medical Center , Stanford, CA , USA.
authors.forename: Jay B
authors.initials: JB
authors.lastname: Brodsky
authors.affiliation: Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University Medical Center , Stanford, CA , USA.
authors.forename: Alex
authors.initials: A
authors.lastname: Macario
keywords: Arthroplasty; Body mass index; Healthcare; Hip replacement; Obesity