The Effect of BMI on Rates of Postoperative Complications after Open Reduction and Internal Fixation of Distal Radius Fractures – A Study on the National Surgical Quality Improvement Project Database

Background: A patient’s Body Mass Index (BMI) has a wide variety of correlations in the orthopedic perioperative setting including post-operative complications. With the current increasing obesity epidemic in the population, understanding the effects of BMI across surgical outcomes can help highlight specific populations that may warrant further management. This study examines the outcomes of patients categorized by BMI receiving operative treatment for distal radius fractures. Methods: A retrospective cohort study was conducted using the American College of Surgeons National Surgical Quality Improvement Program database. Patients who underwent operative management for distal radius fractures between 2007 and 2014 were identified and stratified into groups based on World Health Organization BMI guidelines: (1) \u3c18.5, (2) 18.5-24.9, (3) 25-29.9, (4) \u3e30. Univariate and multivariate analysis were used to evaluate the incidence of multiple adverse events within 30 days after operation. Results: A total of 6,078 subjects were included in this study, with patients who were underweight having the highest percentage of complications at 4.5%. Underweight patients were seen to have an increased likelihood of developing sepsis (p=0.003), myocardial infarction (p\u3c0.001) and progressive renal insufficiency (p\u3c0.001). There were no observed differences seen between BMI groups amongst other comorbidities. Multivariate analysis did not identify BMI as an independent risk factor for any post-operative complications. Conclusion: Relative to non-obese patients (BMI\u3c30), patients with BMI\u3e30 were not observed to be at an increased risk for any post-operative complications. On the contrary patients underweight (BMI\u3c18.5) were found to be at increased risk for developing sepsis, progressive renal insufficiency, and myocardial infarction. Overall complications for operative treatment of distal radius fracture were low for all groups, and patients who stand to benefit from operative treatment should still receive treatment