Obesity Paradox in Orthopaedic Surgery Patients1
Obesity is a known risk factor for the development of cardiovascular disease, hypertension, type 2 diabetes mellitus and chronic kidney disease (CKD). However, former reports suggested that obesity confers a survival advantage in patients with these same chronic diseases, which is known as obesity paradox. A recent analysis on the electronic medical records of 1,783 adult elective orthopedic surgery patients over 2 years in a large academic hospital revealed that obesity, defined as BMI ≥30, increased the likelihood of developing acute kidney injury (AKI) post orthopaedic surgery, whereas AKI increased length of hospital stay and increased the odds of two-year mortality as compared to the non-obese group. Paradoxically, obese patients had a decreased likelihood of two-year mortality. Nonetheless, the results highlighted the debate on the appropriateness of defining obesity using BMI, which is not able to quantify body fat percentage and adiposity distribution, nor the degree of metabolic disturbances that it can underlie.
References
1. Hennrikus et al. Medicine (Baltimore) 2021; 100: e26936.
