Skip to main content

Table 2 Analysis of inpatient complications by Fracture type in the nonoperative and operative groups by Obesity Status

From: Complications of pelvic and acetabular fractures in 1331 morbidly obese patients (BMI ≥ 40): a retrospective observational study from the National Trauma Data Bank

Complication by Fracture Type Nonoperative Group (N = 35,124) Operative Group (N = 11,326)
Controla, % (N) Morbidly Obese, % (N) p Value ORb,c (95% CI) p Value Controla, % (N) Morbidly Obese, % (N) p Value ORb,c (95% CI) p Value
Overall complications
 Pelvic only 3.83 (759) 11.8 (33) < 0.001 2.98 (2.03–4.38) < 0.001 8.42 (118) 20.5 (9) 0.006 2.20 (0.93–5.17) 0.071
 Acetabular only 4.06 (378) 8.38 (29) < 0.001 2.12 (1.41–3.20) < 0.001 6.00 (396) 11.3 (47) < 0.001 1.99 (1.43–2.78) < 0.001
 Pelvic and acetabular 5.35 (280) 11.3 (14) 0.004 2.07 (1.14–3.77) 0.017 10.9 (299) 23.8 (29) < 0.001 2.41 (1.52–3.84) < 0.001
Acute renal failure
 Pelvic only 0.80 (159) 3.57 (10) < 0.001 4.20 (2.16–8.15) < 0.001 1.14 (16) 2.27 (1) 0.493 1.12 (0.12–10.9) 0.922
 Acetabular only 0.73 (68) 1.45 (5) 0.133 1.99 (0.77–5.14) 0.156 0.58 (38) 1.69 (7) 0.006 4.13 (1.73–9.86) 0.001
 Pelvic and acetabular 0.94 (49) 3.23 (4) 0.011 3.17 (1.07–9.38) 0.037 1.13 (31) 5.74 (7) < 0.001 8.43 (3.11–22.8) < 0.001
Acute respiratory distress syndrome
 Pelvic only 0.43 (85) 1.79 (5) 0.001 3.03 (1.17–7.85) 0.023 1.00 (14) 2.27 (1) 0.412 0.99 (0.06–15.7) 0.995
 Acetabular only 0.56 (52) 1.73 (6) 0.006 2.94 (1.21–7.14) 0.017 0.71 (47) 1.45 (6) 0.094 2.04 (0.85–4.89) 0.112
 Pelvic and acetabular 0.36 (19) 1.61 (2) 0.028 4.48 (0.97–20.7) 0.055 1.13 (31) 3.29 (4) 0.035 2.56 (0.82–8.03) 0.107
Bleeding
 Pelvic only 0.19 (37) 1.43 (4) < 0.001 7.15 (2.44–21.0) < 0.001 0.79 (11) 0 (0) 0.555 NA  
 Acetabular only 0.25 (23) 0 (0) 0.354 NA   0.30 (20) 0.48 (2) 0.527 1.73 (0.38–7.84) 0.478
 Pelvic and acetabular 0.38 (20) 0 (0) 0.491 NA   0.69 (19) 0.82 (1) 0.87 1.06 (0.12–9.27) 0.956
Cardiac arrest with CPR
 Pelvic only 0.21 (42) 0 (0) 0.441 NA   0.29 (4) 2.27 (1) 0.027 6.10 (0.14–252) 0.341
 Acetabular only 0.26 (24) 0.58 (2) 0.26 3.11 (0.69–14.0) 0.14 0.08 (5) 0.48 (2) 0.011 9.89 (1.61–60.7) 0.013
 Pelvic and acetabular 0.46 (24) 0 (0) 0.45 NA   0.18 (5) 0.82 (1) 0.132 2.43 (0.24–24.6) 0.451
Coagulopathy
 Pelvic only 0.26 (51) 0.36 (1) 0.743 1.30 (0.17–9.72) 0.8 0.43 (6) 0 (0) 0.664 NA  
 Acetabular only 0.26 (24) 0.58 (2) 0.26 1.72 (0.39–7.64) 0.477 0.20 (13) 0 (0) 0.366 NA  
 Pelvic and acetabular 0.40 (21) 0 (0) 0.48 NA   0.26 (7) 0 (0) 0.576 NA  
Decubitus ulcer
 Pelvic only 0.34 (68) 2.86 (8) < 0.001 7.08 (3.30–15.2) < 0.001 0.93 (13) 2.27 (1) 0.37 1.86 (0.17–20.4) 0.613
 Acetabular only 0.43 (40) 0.58 (2) 0.682 1.44 (0.35–3.72) 0.882 0.59 (39) 1.69 (7) 0.007 2.12 (1.17–3.83) 0.013
 Pelvic and acetabular 0.73 (38) 2.42 (3) 0.032 2.68 (0.75–9.56) 0.129 1.10 (30) 4.92 (6) < 0.001 4.61 (1.72–12.4) 0.002
Deep surgical site infection
 Pelvic only NA NA NA 2.40 (0.73–7.85) 0.147 0.14 (2) 0 (0) 0.802 1.63 (0.32–8.28) 0.557
 Acetabular only NA NA NA 1.28 (0.30–5.50) 0.742 0.05 (3) 0.24 (1) 0.105 2.89 (1.24–6.72) 0.014
 Pelvic and acetabular NA NA NA 2.18 (0.65–7.39) 0.209 0.11 (3) 0 (0) 0.715 2.97 (1.49–5.95) 0.002
DVT/thrombophlebitis
 Pelvic only 0.36 (72) 1.07 (3) 0.053    2.21 (31) 4.55 (2) 0.308 NA  
 Acetabular only 0.66 (61) 0.87 (3) 0.635    1.54 (102) 3.37 (14) 0.005 NA  
 Pelvic and acetabular 0.86 (45) 2.42 (3) 0.068    3.10 (85) 9.84 (12) < 0.001 NA  
Myocardial infarction
 Pelvic only 0.29 (58) 0.36 (1) 0.842 1.22 (0.17–8.93) 0.845 0 (0) 2.27 (1) < 0.001 NA  
 Acetabular only 0.18 (17) 0.58 (2) 0.104 4.71 (0.99–22.4) 0.052 0.17 (11) 0.48 (2) 0.147 4.96 (0.97–25.3) 0.054
 Pelvic and acetabular 0.25 (13) 0 (0) 0.579 NA   0.40 (11) 0.82 (1) 0.484 0.99 (0.07–14.7) 0.996
Organ/deep space infection
 Pelvic only 1.26 (250) 3.57 (10) 0.001 2.36 (1.22–4.57) 0.011 3.28 (46) 11.36 (5) 0.004 2.84 (0.93–8.66) 0.067
 Acetabular only 1.26 (117) 2.02 (7) 0.215 1.72 (0.78–3.83) 0.179 1.39 (92) 1.93 (8) 0.372 1.35 (0.64–2.85) 0.427
 Pelvic and acetabular 1.68 (88) 4.84 (6) 0.008 2.89 (1.19–6.97) 0.018 3.10 (85) 6.56 (8) 0.035 1.85 (0.85–4.05) 0.127
Pulmonary embolism
 Pelvic only 0.27 (53) 0.36 (1) 0.773 1.32 (0.18–9.65) 0.785 1.28 (18) 0 (0) 0.449 NA  
 Acetabular only 0.44 (41) 1.45 (5) 0.008 3.11 (1.19–8.17) 0.21 1.17 (77) 2.17 (9) 0.072 1.95 (0.05–4.01) 0.069
 Pelvic and acetabular 0.42 (22) 0.81 (1) 0.515 1.41 (0.18–11.2) 0.747 1.53 (42) 4.10 (5) 0.029 2.34 (0.87–6.33) 0.092
Stroke/CVA
 Pelvic only 0.07 (14) 0 (0) 0.657 NA   0.14 (2) 0 (0) 0.802 NA  
 Acetabular only 0.06 (6) 0.29 (1) 0.128 4.38 (0.44–43.5) 0.207 0.05 (3) 0 (0) 0.664 NA  
 Pelvic and acetabular 0.08 (4) 0 (0) 0.758 NA   0.37 (10) 0.82 (1) 0.427 1.92 (0.22–16.9) 0.555
Superficial SSI
 Pelvic only NA NA NA    0.29 (4) 2.27 (1) 0.143 8.12 (0.89–74.2) 0.064
 Acetabular only NA NA NA    0.26 (17) 0.48 (2) 0.311 1.88 (0.43–8.15) 0.401
 Pelvic and acetabular NA NA NA    0.33 (9) 2.46 (3) 0.013 7.65 (2.04–28.6) 0.003
Systemic sepsis
 Pelvic only 0.29 (57) 1.07 (3) 0.017 3.62 (1.10–11.9) 0.034 1.07 (15) 0 (0) 0.49 NA  
 Acetabular only 0.45 (42) 1.16 (4) 0.062 2.45 (0.83–6.27) 0.106 0.42 (28) 1.20 (5) 0.024 3.18 (1.17–8.66) 0.023
 Pelvic and acetabular 0.38 (20) 1.61 (2) 0.034 3.01 (0.65–14.1) 0.161 0.84 (23) 4.10 (5) < 0.001 4.40 (1.52–12.73) 0.006
Wound disruption
 Pelvic only NA NA NA    0.07 (1) 0 (0) 0.859 NA  
 Acetabular only NA NA NA    0. 06 (4) 0.24 (1) 0.181 6.10 (0.51–73.69) 0.155
 Pelvic and acetabular NA NA NA    0.29 (8) 0 (0) 0.55 NA  
  1. CI confidence interval, CPR cardiopulmonary resuscitation, CVA cerebrovascular accident, DVT deep venous thrombosis, NA not applicable, OR odds ratio, SSI surgical site infection
  2. aPatients with body mass index values < 40
  3. bNA signifies that there was no significant difference between the groups, and too much colinearity existed to calculate an actual OR
  4. cAdjusted for age, sex, race/ethnicity, insurance status, injury characteristics (Injury Severity Score, Abbreviated Injury Score, mechanism), presence/absence of hypotension on admission, hospital factors (trauma level, teaching status), and treatment type (open reduction with internal fixation, internal fixation, or external fixation)