Morbid obesity and 1-year costs after elbow dislocation

Area of Science:

• Orthopedic Surgery
• Health Economics
• Obesity Medicine

Background:

• Morbid obesity is associated with severe injuries after knee dislocations.
• Elbow dislocations in obese patients may lead to devastating injuries.
• The financial impact of elbow dislocations in morbidly obese individuals remains uncharacterized.

Purpose of the Study:

• To determine the impact of morbid obesity on 1-year costs associated with elbow dislocation.
• To compare the financial burden of elbow dislocation treatment between morbidly obese and non-morbidly obese patients.

Main Methods:

• Retrospective analysis of Medicare Standard Analytic Files (2005-2014).
• Comparison of 1-year reimbursement costs for open or closed elbow reduction in morbidly obese (BMI ≥ 40 kg/m²) versus non-morbidly obese patients (BMI < 40 kg/m²).
• Cohorts matched for age and gender; analysis of total reimbursement costs for elbow dislocation and reduction.

Main Results:

• Identified 182 morbidly obese and 422 non-morbidly obese patients with elbow dislocations.
• After matching, 102 patients remained in each cohort for 1-year cost analysis.
• Mean 1-year reimbursement costs were significantly higher for morbidly obese patients ($6227.43) compared to non-morbidly obese patients ($4225.71, p=0.006).

Conclusions:

• 1-year costs for elbow dislocation are significantly elevated in morbidly obese individuals.
• Increased costs are likely due to the complexity of managing dislocations in obese patients.
• Factors contributing to higher costs include surgical complexity, higher complication rates, and peri-operative medical issues.