Does obesity predict morbidity and mortality amongst patients undergoing transfemoral amputations?

Background: We investigated the role of obesity on morbidity and mortality in patients undergoing above knee amputation. Methods: Data of 4225 patients undergoing AKAs was extracted from NIS Database (2016–2019) for a retrospectively matched case-control study and were grouped into; Non-obese (N-Ob-BMI <29.9 kg/m²; n = 1413), class I/II obese (Ob-I/II-BMI: 30–39.9 kg/m²; n = 1413), and class III obese groups (Ob-IIIBMI > 40; n = 1399). Morbidity, mortality, length of stay, and hospital charges were analyzed. Results: Blood loss anemia (OR = 1.42; 95% CI = 1.19–1.64), superficial SSI (OR = 5.10; 95% CI = 1.4717.63) and acute kidney injury (AKI- OR = 1.42; 95% CI = 1.21–1.67) were higher in Ob-III patients. Mortality was 5.8%, 4.5%, and 6.4% in N-Ob, Ob-I/II and Ob-III patients (p < 0.001; Ob-I/II vs. Ob-III), respectively. Hospital LOS was 3 days higher in Ob-III (16.1 ± 18.0), comparatively resulting in $25,481 higher inpatient-hospital charge. Conclusion: Patients in Ob-III group were noted to have increased morbidity, higher LOS, and inpatient-hospital cost.