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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)
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Patient Safety in Surgery

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