Effect of Obesity on Outcomes of Forefoot Surgery

Matthew S. Stewart, Clayton C. Bettin, Matthew T. Ramsey, Susan N. Ishikawa, G. Andrew Murphy, David R. Richardson, Elizabeth Tolley

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Background: Forefoot surgery typically is elective, so it is important to define risk factors to educate patients on potential complications. The purpose of this study was to determine if obesity is an independent risk factor that contributes to increased complication rates after forefoot surgery. Methods: Through a retrospective review of records, 633 patients were identified who had forefoot surgery at one institution between 2008 and 2010. All patients who currently smoked or smoked in the past were excluded to eliminate a confounding factor, as smoking is known to increase complication rates, leaving 427 patients for inclusion, 299 nonobese (BMI less than 30) and 128 obese (BMI more than 30). Medical records were reviewed for the occurrence of complications, including nonunion, delayed union, delayed wound healing, infection, and persistent pain. Results: The overall complication rate was 9%, with similar rates between obese (10%) and nonobese patients (9%). The only specific complication approaching significance (P =.13) was a higher rate of infection in obese patients (4 % compared to 1%), which could be attributed to the higher percentage of diabetic patients in the obese group. Diabetic patients, regardless of weight, had significantly higher rates of infection (P =.03), with a trend toward higher rates of overall complications and delayed wound healing (P =.08 and P <.06, respectively). Conclusion: Obesity was not shown to lead to more frequent complications after forefoot surgery. Diabetes was associated with significantly higher rates of infection, regardless of weight. Though not significant, there was a trend toward higher rates of overall complications and delayed wound healing in diabetic patients as well. Level of Evidence: Level III, retrospective comparative study.

Original languageEnglish (US)
Pages (from-to)483-487
Number of pages5
JournalFoot and Ankle International
Volume37
Issue number5
DOIs
StatePublished - Jan 1 2016

Fingerprint

Obesity
Wound Healing
Infection
Weights and Measures
Wound Infection
Medical Records
Retrospective Studies
Smoking
Pain

All Science Journal Classification (ASJC) codes

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

Stewart, M. S., Bettin, C. C., Ramsey, M. T., Ishikawa, S. N., Murphy, G. A., Richardson, D. R., & Tolley, E. (2016). Effect of Obesity on Outcomes of Forefoot Surgery. Foot and Ankle International, 37(5), 483-487. https://doi.org/10.1177/1071100715624209

Effect of Obesity on Outcomes of Forefoot Surgery. / Stewart, Matthew S.; Bettin, Clayton C.; Ramsey, Matthew T.; Ishikawa, Susan N.; Murphy, G. Andrew; Richardson, David R.; Tolley, Elizabeth.

In: Foot and Ankle International, Vol. 37, No. 5, 01.01.2016, p. 483-487.

Research output: Contribution to journalArticle

Stewart, MS, Bettin, CC, Ramsey, MT, Ishikawa, SN, Murphy, GA, Richardson, DR & Tolley, E 2016, 'Effect of Obesity on Outcomes of Forefoot Surgery', Foot and Ankle International, vol. 37, no. 5, pp. 483-487. https://doi.org/10.1177/1071100715624209
Stewart MS, Bettin CC, Ramsey MT, Ishikawa SN, Murphy GA, Richardson DR et al. Effect of Obesity on Outcomes of Forefoot Surgery. Foot and Ankle International. 2016 Jan 1;37(5):483-487. https://doi.org/10.1177/1071100715624209
Stewart, Matthew S. ; Bettin, Clayton C. ; Ramsey, Matthew T. ; Ishikawa, Susan N. ; Murphy, G. Andrew ; Richardson, David R. ; Tolley, Elizabeth. / Effect of Obesity on Outcomes of Forefoot Surgery. In: Foot and Ankle International. 2016 ; Vol. 37, No. 5. pp. 483-487.
@article{7bcc9c177f364383a3247b85a9ce5321,
title = "Effect of Obesity on Outcomes of Forefoot Surgery",
abstract = "Background: Forefoot surgery typically is elective, so it is important to define risk factors to educate patients on potential complications. The purpose of this study was to determine if obesity is an independent risk factor that contributes to increased complication rates after forefoot surgery. Methods: Through a retrospective review of records, 633 patients were identified who had forefoot surgery at one institution between 2008 and 2010. All patients who currently smoked or smoked in the past were excluded to eliminate a confounding factor, as smoking is known to increase complication rates, leaving 427 patients for inclusion, 299 nonobese (BMI less than 30) and 128 obese (BMI more than 30). Medical records were reviewed for the occurrence of complications, including nonunion, delayed union, delayed wound healing, infection, and persistent pain. Results: The overall complication rate was 9{\%}, with similar rates between obese (10{\%}) and nonobese patients (9{\%}). The only specific complication approaching significance (P =.13) was a higher rate of infection in obese patients (4 {\%} compared to 1{\%}), which could be attributed to the higher percentage of diabetic patients in the obese group. Diabetic patients, regardless of weight, had significantly higher rates of infection (P =.03), with a trend toward higher rates of overall complications and delayed wound healing (P =.08 and P <.06, respectively). Conclusion: Obesity was not shown to lead to more frequent complications after forefoot surgery. Diabetes was associated with significantly higher rates of infection, regardless of weight. Though not significant, there was a trend toward higher rates of overall complications and delayed wound healing in diabetic patients as well. Level of Evidence: Level III, retrospective comparative study.",
author = "Stewart, {Matthew S.} and Bettin, {Clayton C.} and Ramsey, {Matthew T.} and Ishikawa, {Susan N.} and Murphy, {G. Andrew} and Richardson, {David R.} and Elizabeth Tolley",
year = "2016",
month = "1",
day = "1",
doi = "10.1177/1071100715624209",
language = "English (US)",
volume = "37",
pages = "483--487",
journal = "Foot and Ankle International",
issn = "1071-1007",
publisher = "AOFAS - American Orthopaedic Foot and Ankle Society",
number = "5",

}

TY - JOUR

T1 - Effect of Obesity on Outcomes of Forefoot Surgery

AU - Stewart, Matthew S.

AU - Bettin, Clayton C.

AU - Ramsey, Matthew T.

AU - Ishikawa, Susan N.

AU - Murphy, G. Andrew

AU - Richardson, David R.

AU - Tolley, Elizabeth

PY - 2016/1/1

Y1 - 2016/1/1

N2 - Background: Forefoot surgery typically is elective, so it is important to define risk factors to educate patients on potential complications. The purpose of this study was to determine if obesity is an independent risk factor that contributes to increased complication rates after forefoot surgery. Methods: Through a retrospective review of records, 633 patients were identified who had forefoot surgery at one institution between 2008 and 2010. All patients who currently smoked or smoked in the past were excluded to eliminate a confounding factor, as smoking is known to increase complication rates, leaving 427 patients for inclusion, 299 nonobese (BMI less than 30) and 128 obese (BMI more than 30). Medical records were reviewed for the occurrence of complications, including nonunion, delayed union, delayed wound healing, infection, and persistent pain. Results: The overall complication rate was 9%, with similar rates between obese (10%) and nonobese patients (9%). The only specific complication approaching significance (P =.13) was a higher rate of infection in obese patients (4 % compared to 1%), which could be attributed to the higher percentage of diabetic patients in the obese group. Diabetic patients, regardless of weight, had significantly higher rates of infection (P =.03), with a trend toward higher rates of overall complications and delayed wound healing (P =.08 and P <.06, respectively). Conclusion: Obesity was not shown to lead to more frequent complications after forefoot surgery. Diabetes was associated with significantly higher rates of infection, regardless of weight. Though not significant, there was a trend toward higher rates of overall complications and delayed wound healing in diabetic patients as well. Level of Evidence: Level III, retrospective comparative study.

AB - Background: Forefoot surgery typically is elective, so it is important to define risk factors to educate patients on potential complications. The purpose of this study was to determine if obesity is an independent risk factor that contributes to increased complication rates after forefoot surgery. Methods: Through a retrospective review of records, 633 patients were identified who had forefoot surgery at one institution between 2008 and 2010. All patients who currently smoked or smoked in the past were excluded to eliminate a confounding factor, as smoking is known to increase complication rates, leaving 427 patients for inclusion, 299 nonobese (BMI less than 30) and 128 obese (BMI more than 30). Medical records were reviewed for the occurrence of complications, including nonunion, delayed union, delayed wound healing, infection, and persistent pain. Results: The overall complication rate was 9%, with similar rates between obese (10%) and nonobese patients (9%). The only specific complication approaching significance (P =.13) was a higher rate of infection in obese patients (4 % compared to 1%), which could be attributed to the higher percentage of diabetic patients in the obese group. Diabetic patients, regardless of weight, had significantly higher rates of infection (P =.03), with a trend toward higher rates of overall complications and delayed wound healing (P =.08 and P <.06, respectively). Conclusion: Obesity was not shown to lead to more frequent complications after forefoot surgery. Diabetes was associated with significantly higher rates of infection, regardless of weight. Though not significant, there was a trend toward higher rates of overall complications and delayed wound healing in diabetic patients as well. Level of Evidence: Level III, retrospective comparative study.

UR - http://www.scopus.com/inward/record.url?scp=84966292083&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84966292083&partnerID=8YFLogxK

U2 - 10.1177/1071100715624209

DO - 10.1177/1071100715624209

M3 - Article

VL - 37

SP - 483

EP - 487

JO - Foot and Ankle International

JF - Foot and Ankle International

SN - 1071-1007

IS - 5

ER -