The Metabolic Syndrome Paradox: Increased Morbidity and Decreased Mortality in Operative Orthopedic Trauma

Victoria Kravets; Christopher Staley; Jacob Wilson; Andrew Schwartz; Mara Schenker

doi:10.3928/01477447-20211227-10

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The Metabolic Syndrome Paradox: Increased Morbidity and Decreased Mortality in Operative Orthopedic Trauma

Journal article

Peer reviewed

The Metabolic Syndrome Paradox: Increased Morbidity and Decreased Mortality in Operative Orthopedic Trauma

Victoria Kravets, Christopher Staley, Jacob Wilson, Andrew Schwartz and Mara Schenker

Orthopedics (Thorofare, N.J.), Vol.45(2), pp.103-108

03/01/2022

DOI: 10.3928/01477447-20211227-10

PMID: 34978507

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Abstract

We examined the impact of metabolic syndrome (MetS) on operative outcomes with orthopedic trauma, particularly among patients with pelvic, acetabular, and lower extremity fractures. This retrospective cohort study used the American College of Surgeons National Surgical Quality Improvement Program database to identify patients who had operative pelvic, acetabular, and lower extremity trauma from 2006 through 2014. We defined MetS as type 2 diabetes, a history of hypertension requiring medication, and body mass index of 30 kg/m2 or greater. Patients with MetS were compared with unaffected patients and assessed for association with in-hospital complications and mortality. The study population included 37,495 patients; 5.7% (n=2154) had MetS. On multivariable logistic regression, MetS was associated with increased odds of any hospital complication (odds ratio [OR], 1.30; 95% CI, 1.13–1.51; P<.001), Clavien-Dindo grade IV complications (OR, 1.51; 95% CI, 1.23–1.87; P<.001), readmission (OR, 1.39; 95% CI, 1.18–1.63; P<.001), and reoperation (OR, 1.40; 95% CI, 1.11–1.76; P=.004). Conversely, MetS significantly decreased the odds of mortality (OR, 0.67; 95% CI, 0.49–0.92; P=.01). Although MetS is a risk factor for postoperative complications, longer length of stay, and increased readmission after surgical intervention for orthopedic lower extremity trauma, MetS appears to decrease the odds of mortality in this specific patient population, which merits further investigation. [Orthopedics. 2022;45(2):103–108.]

Blood transfusions

Body mass index

Bone surgery

Heart attacks

Hypertension

Insulin resistance

Length of stay

Medical personnel

Metabolic syndrome

Mortality

Orthopedics

Patients

Pelvis

Pneumonia

Prostheses

Pulmonary embolisms

Sepsis

Thrombosis

Trauma

Urinary tract diseases

Urinary tract infections

Urogenital system

Ventilation

Ventilators

Wound dehiscence

Details

Title: Subtitle: The Metabolic Syndrome Paradox: Increased Morbidity and Decreased Mortality in Operative Orthopedic Trauma
Creators: Victoria Kravets
Christopher Staley
Jacob Wilson
Andrew Schwartz
Mara Schenker
Resource Type: Journal article
Publication Details: Orthopedics (Thorofare, N.J.), Vol.45(2), pp.103-108
Publisher: SLACK INCORPORATED
DOI: 10.3928/01477447-20211227-10
PMID: 34978507
ISSN: 0147-7447
eISSN: 1938-2367
Language: English
Date published: 03/01/2022
Academic Unit: Orthopedics and Rehabilitation
Record Identifier: 9984303970702771

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