{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,16]],"date-time":"2026-05-16T16:32:14Z","timestamp":1778949134748,"version":"3.51.4"},"reference-count":34,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:sec>\n            <jats:title>Objective:<\/jats:title>\n            <jats:p>Paradoxically, overweight and obesity are associated with lower odds of complications and death after hip fracture surgery. Our objective was to determine whether this \u201cobesity paradox\u201d extends to patients with \u201csuperobesity.\u201d In this study, we compared rates of complications and death among superobese patients with those of patients in other body mass index (BMI) categories.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods:<\/jats:title>\n            <jats:p>Using the National Surgical Quality Improvement Program database, we identified &gt;100,000 hip fracture surgeries performed from 2012 to 2018. Patients were categorized as underweight (BMI &lt;18.5), normal weight (BMI 18.5\u201324.9), overweight (BMI 25\u201329.9), obese (BMI 30\u201339.9), morbidly obese (BMI 40\u201349.9), or superobese (BMI \u226550). We analyzed patient characteristics, surgical characteristics, and 30-day outcomes. Using multivariate regression with normal-weight patients as the referent, we determined odds of major complications, minor complications, and death within 30 days by BMI category.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>Of 440 superobese patients, 20% had major complications, 33% had minor complications, and 5.2% died within 30 days after surgery. When comparing patients in other BMI categories with normal-weight patients, superobese patients had the highest odds of major complications [odds ratio (OR): 1.6, 95% confidence interval (CI), 1.2\u20132.0] but did not have significantly different odds of death (OR: 0.91, 95% CI, 0.59\u20131.4) or minor complications (OR: 1.2, 95% CI, 0.94\u20131.4).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion:<\/jats:title>\n            <jats:p>Superobese patients had significantly higher odds of major complications within 30 days after hip fracture surgery compared with all other patients. This \u201cobesity paradox\u201d did not apply to superobese patients.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Level of Evidence:<\/jats:title>\n            <jats:p>Prognostic Level III. See Instructions for Authors for a Complete Description of Levels of Evidence.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/bot.0000000000001987","type":"journal-article","created":{"date-parts":[[2020,11,9]],"date-time":"2020-11-09T02:00:11Z","timestamp":1604887211000},"page":"322-328","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":12,"title":["Complications and 30-Day Mortality Rate After Hip Fracture Surgery in Superobese Patients"],"prefix":"10.1097","volume":"35","author":[{"given":"Yash P.","family":"Chaudhry","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sandesh S.","family":"Rao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Varun","family":"Puvanesarajah","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raj M.","family":"Amin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Harpal S.","family":"Khanuja","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julius K.","family":"Oni","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erik A.","family":"Hasenboehler","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert S.","family":"Sterling","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"R1-20250614","doi-asserted-by":"crossref","first-page":"810","DOI":"10.1093\/ije\/dyz273","article-title":"Has the prevalence of overweight, obesity and central obesity levelled off in the United States? 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