ArticleActa orthopaedica2014
Body mass index and risk of perioperative cardiovascular adverse events and mortality in 34,744 Danish patients undergoing hip or knee replacement.
Article in Acta orthopaedica, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers, 2 of them syntheses that pooled it.
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Who cites it
30 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Risk factors associated with cardiac complication after total joint arthroplasty of the hip and knee: a systematic review.Journal of orthopaedic surgery and research · 2019Pooled it
- Factors influencing harmonized health data collection, sharing and linkage in Denmark and Switzerland: A systematic review.PloS one · 2019Pooled it
- Fully automated, deep learning, cardiac CT-based multimodal network for cardiovascular risk stratification in high-risk perioperative patients.European heart journal. Digital health · 2026Article
- Differential Pattern of Obesity in Total Hip and Knee Arthroplasty Candidates.Physiotherapy Canada. Physiotherapie Canada · 2025Article
- The risk analysis of perioperative complications of cementless hip arthroplasty in octogenarians.Archives of orthopaedic and trauma surgery · 2023Article
- Patients successfully lose body weight after primary total knee arthroplasty but not more than a matched general population.Archives of orthopaedic and trauma surgery · 2023Article
- Fast Track Protocols and Early Rehabilitation after Surgery in Total Hip Arthroplasty: A Narrative Review.Clinics and practice · 2023Review
- How to Distinguish Correlation From Causation in Orthopaedic Research.The Journal of arthroplasty · 2023Review
- Impact of being underweight on peri-operative and post-operative outcomes of total knee or hip arthroplasty: A meta-analysis.World journal of clinical cases · 2022Article
- Observational
- Article
- Obesity and revision surgery, mortality, and patient-reported outcomes after primary knee replacement surgery in the National Joint Registry: A UK cohort study.PLoS medicine · 2021Article
- The Association Between BMI and Mortality in Surgical Patients.World journal of surgery · 2021Article
- Pre-operative clinical predictors for cardiology referral prior to total joint arthroplasty: the 'asymptomatic' patient.Journal of orthopaedic surgery and research · 2020Article
- A small number of surgeons outside the control-limit: an observational study based on 9,482 cases and 208 surgeons performing primary total hip arthroplasties in western Sweden.Acta orthopaedica · 2020Observational
- Incidence, predictors, and timing of post-operative stroke following elective total hip arthroplasty and total knee arthroplasty.PloS one · 2020Article
- Change in the cause of inpatient mortality after arthroplasty: a retrospective study.Journal of orthopaedic surgery and research · 2019Article
- Statistical Methods Dictate the Estimated Impact of Body Mass Index on Major and Minor Complications After Total Joint Arthroplasty.Clinical orthopaedics and related research · 2018Article
- Myocardial infarction following fast-track total hip and knee arthroplasty-incidence, time course, and risk factors: a prospective cohort study of 24,862 procedures.Acta orthopaedica · 2018Observational
- Echocardiographic measurements of epicardial adipose tissue and comparative ability to predict adverse cardiovascular outcomes in patients with coronary artery disease.The international journal of cardiovascular imaging · 2018Observational
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6 authors.
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No grant is acknowledged in the PubMed record.
Abstract
background and purposeObesity is a risk factor for osteoarthritis in the lower limb, yet the cardiovascular risks associated with obesity in hip or knee replacement surgery are unknown. We examined associations between body mass index (BMI) and the risk of a major adverse cardiovascular event (MACE: ischemic stroke, acute myocardial infarction, or cardiovascular death) or the risk of all-cause mortality in a nationwide Danish cohort of patients who underwent primary hip or knee replacement surgery.
methodsUsing Danish nationwide registries, we identified 34,744 patients aged ≥ 20 years who underwent elective primary hip or knee replacement surgery between 2005 and 2011. We used multivariable Cox regression models to calculate the 30-day risks of MACE and mortality associated with 5 BMI groups (underweight (BMI < 18.5 kg/m(2)), normal weight (18.5-24 kg/m(2)), overweight (25-29 kg/m(2)), obese 1 (30-34 kg/m(2)), and obese 2 (≥ 35 kg/m(2))).
resultsIn total, 232 patients (0.7%) had a MACE and 111 (0.3%) died. Compared with overweight, adjusted hazard ratios (HRs) were 1.2 (95% CI: 0.4-3.3), 1.3 (0.95-1.8), 1.6 (1.1-2.2), and 1.0 (0.6-1.9) for underweight, normal weight, obese 1, and obese 2 regarding MACE. Regarding mortality, the corresponding HRs were 7.0 (2.8-15), 2.0 (1.2-3.2), 1.5 (0.9-2.7), and 1.9 (0.9-4.2). Cubic splines suggested a significant U-shaped relationship between BMI and risks with nadir around 27-28.
interpretationIn an unselected cohort of patients undergoing elective primary hip or knee replacement surgery, U-shaped risks of perioperative MACE and mortality were found in relation to BMI. Patients within the extreme ranges of BMI may warrant further attention.
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