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Effect of Metabolic Syndrome on Postoperative Complications Following Hand Surgery
Joshua W. Hustedt, MD, MHS1; Jill Goodwin, MD1; Andrew Chung, DO1; Daniel Bohl, MD2; Neil Olmscheid, BA3; Scott Edwards, MD4
1University of Arizona College of Medicine- Phoenix, Phoenix, AZ, 2Rush University, Chicago, IL, 3Arizona College of Osteopathic Medicine, Glendale, AZ, 4The CORE Institute, Phoenix, AZ
Introduction: Metabolic syndrome has been associated with adverse postoperative outcomes in many surgical fields. This study was designed to identify the risk of postoperative outcomes associated with metabolic syndrome following hand surgery.
Materials & Methods: A retrospective cohort study of patients undergoing a variety of hand-specific surgeries was conducted using the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database from 2005-2013. 912 patients with metabolic syndrome were compared to 26,183 without metabolic syndrome. Metabolic syndrome was defined as the presence of hypertension, diabetes, and body mass index of 30.0 kg/m2 or greater. Metabolic syndrome was tested for association with 30-day postoperative complications.
Results: Patients with metabolic syndrome had greater risk of complications as compared to patients without metabolic syndrome (5.3% vs 2.0%, p<0.001). In a multivariate analysis controlling for patient and procedural factors, metabolic syndrome (odds ratio 1.5, 95% confidence interval 1.1-2.3, p=0.03) was associated with an increase in risk of postoperative complications.
Conclusion: Metabolic syndrome was found to be associated with increased risk for postoperative complications following hand surgery. Patients with metabolic syndrome should be appropriately counseled on this increased risk and should be targeted for clinical interventions to control perioperative risk factors in preparation for hand surgery.
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