Underweight patients experience higher inpatient complication and mortality rates following acetabular fracture

Area of Science:

• Orthopaedic Surgery
• Trauma Surgery
• Patient Outcomes

Background:

• Underweight patients often experience poorer outcomes following elective orthopaedic procedures.
• The specific impact of underweight body mass index (BMI) on acetabular fracture complications is not well-documented.

Purpose of the Study:

• To investigate the association between underweight status and inpatient complications after acetabular fractures.
• To compare complication and mortality rates between underweight and normal-weight patients.

Main Methods:

• Analysis of adult patients (≥18 years) with acetabular fractures from 2015-2019 using Trauma Quality Program data.
• Multivariable logistic regression was used to compare adjusted odds of inpatient complications and mortality between underweight (BMI <18.5 kg/m²) and normal-weight (BMI 18.5-25 kg/m²) patients.
• Analysis was stratified by age (≥65 years vs. 18-64 years).

Main Results:

• Underweight patients aged ≥65 years had significantly higher odds of any inpatient complication (aOR 1.2) and inpatient mortality (aOR 2.7) compared to normal-weight counterparts.
• Underweight patients aged 18-64 years also showed increased odds of any inpatient complication (aOR 1.2) and inpatient mortality (aOR 1.5) versus normal-weight patients.
• Specific complication rates and p-values were detailed for both age groups.

Conclusions:

• Underweight status is a significant risk factor for increased inpatient complications and mortality in adult patients with acetabular fractures.
• Older adult patients (≥65 years) who are underweight experience a particularly elevated risk.
• These findings highlight the importance of nutritional status in managing acetabular fracture patients.