title: Effect of Obesity on Complication Rate After Elbow Arthroscopy in a Medicare Population.
abstract: OBJECTIVE
  To use a national insurance database to explore the association of obesity with the incidence of complications after elbow arthroscopy in a Medicare population.
  
  
  METHODS
  Using Current Procedural Terminology (CPT) and International Classification of Diseases, 9th Revision (ICD-9) procedure codes, we queried the PearlDiver database for patients undergoing elbow arthroscopy. Patients were divided into obese (body mass index [BMI] >30) and nonobese (BMI <30) cohorts using ICD-9 codes for BMI and obesity. Nonobese patients were matched to obese patients based on age, sex, tobacco use, diabetes, and rheumatoid arthritis. Postoperative complications were assessed with ICD-9 and Current Procedural Terminology codes, including infection, nerve injury, stiffness, and medical complications.
  
  
  RESULTS
  A total of 2,785 Medicare patients who underwent elbow arthroscopy were identified from 2005 to 2012; 628 patients (22.5%) were coded as obese or morbidly obese, and 628 matched nonobese patients formed the control group. There were no differences between the obese patients and matched control nonobese patients regarding type of elbow arthroscopy, previous elbow fracture or previous elbow arthroscopy. Obese patients had greater rates of all assessed complications, including infection (odds ratio [OR] 2.8, P = .037), nerve injury (OR 5.4, P = .001), stiffness (OR 1.9, P = .016) and medical complications (OR 6.9, P < .0001).
  
  
  CONCLUSIONS
  Obesity is associated with significantly increased rates of all assessed complications after elbow arthroscopy in a Medicare population, including infection, nerve injury, stiffness, and medical complications.
  
  
  METHODS
  Therapeutic Level III, case-control study.
authors.affiliation: Department of Orthopaedic Surgery, University of Virginia Health System, Charlottesville, Virginia, U.S.A.
authors.forename: Brian C
authors.initials: BC
authors.lastname: Werner
authors.affiliation: Department of Orthopaedic Surgery, University of Virginia Health System, Charlottesville, Virginia, U.S.A.
authors.forename: Ahmad H
authors.initials: AH
authors.lastname: Fashandi
authors.affiliation: Department of Orthopaedic Surgery, University of Virginia Health System, Charlottesville, Virginia, U.S.A.
authors.forename: A Bobby
authors.initials: AB
authors.lastname: Chhabra
authors.affiliation: Department of Orthopaedic Surgery, University of Virginia Health System, Charlottesville, Virginia, U.S.A.. Electronic address: dnd2t@hscmail.mcc.virginia.edu.
authors.forename: D Nicole
authors.initials: DN
authors.lastname: Deal
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001182:Arthroscopy / Q000009:adverse effects*; D015992:Body Mass Index; D004551:Elbow Joint / Q000601:surgery*; D005260:Female; D006801:Humans; D015994:Incidence; D007592:Joint Diseases / Q000150:complications / Q000601:surgery*; D008297:Male; D006278:Medicare; D009767:Obesity, Morbid / Q000150:complications*; D016017:Odds Ratio; D011183:Postoperative Complications / Q000453:epidemiology*; D012086:Reoperation; D012189:Retrospective Studies; D014481:United States / Q000453:epidemiology