Economic burden of obesity in primary total knee arthroplasty
Article first published online: 27 SEP 2011
Copyright © 2011 by the American College of Rheumatology
Arthritis Care & Research
Volume 63, Issue 10, pages 1375–1381, October 2011
How to Cite
Dowsey, M. M., Liew, D. and Choong, P. F. M. (2011), Economic burden of obesity in primary total knee arthroplasty. Arthritis Care Res, 63: 1375–1381. doi: 10.1002/acr.20563
- Issue published online: 27 SEP 2011
- Article first published online: 27 SEP 2011
- Accepted manuscript online: 26 JUL 2011 11:14AM EST
- Manuscript Accepted: 11 JUL 2011
- Manuscript Received: 4 NOV 2010
To compare the hospital inpatient costs between nonobese and obese patients and estimate the economic burden of obesity in primary total knee arthroplasty (TKA).
A cost identification study was conducted in a consecutive cohort of 530 patients who underwent TKA between 2006 and 2007 at a university-affiliated tertiary referral center in Melbourne, Australia. Total hospital inpatient costs incurred at the study institution associated with the index surgery and subsequent related emergency presentations and readmissions during the episode of care were captured. Predictor variables of interest were obesity and body mass index (BMI), and the outcomes of interest were total hospital inpatient costs for the index surgery and episode of care, defined as the first 12 months following TKA. Multivariate linear regression techniques were used to examine the association between the predictors of interest and hospital costs, adjusting for clinically relevant variables.
Economic data were analyzed in 521 patients, of which 317 (60.8%) were obese. Obesity was associated with higher inpatient index surgery costs (+$1,226.89 [95% confidence interval (95% CI) $82.25, $2,371.52]; P = 0.036) and episode of care costs (+$1,821.36 [95% CI $244.93, $3,397.79]; P = 0.024). Each unit increase in BMI was also associated with higher inpatient index surgery costs ($128.91 [95% CI $34.53, $223.28]; P = 0.008) and total episode of care costs ($158.79 [95% CI $28.54, $289.05]; P = 0.017).
The estimated significant additional annual obesity-related expenditure reported in this study establishes a rationale to trial and evaluate interventions that target weight loss in obese patients undergoing TKA from both a quality of life and economic perspective.