{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,2]],"date-time":"2025-11-02T11:40:44Z","timestamp":1762083644351,"version":"build-2065373602"},"reference-count":20,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2022,12,29]],"date-time":"2022-12-29T00:00:00Z","timestamp":1672272000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>This study assesses the effect of obesity classes on outcomes and inpatient-hospital-cost compared to non-obese individuals undergoing below-knee amputations (BKAs). Retrospective matched-case controlled study performed on data from NIS Database. We identified three groups: N-Ob (BMI &lt; 29.9 kg\/m2; n = 3104), Ob-I\/II (BMI: 30 to 39.9 kg\/m2; n = 3107), and Ob-III (BMI &gt; 40; n = 3092); matched for gender, comorbidities, tobacco use and elective vs. emergent surgery. Differences in morbidity, mortality, hospital length of stay (LOS), and total inpatient cost were analyzed. Blood loss anemia was more common in Ob-III compared to Ob-I\/II patients (OR = 1.2; 95% CI = 1.1\u20131.4); blood transfusions were less commonly required in Ob-I\/II (OR = 0.8; 95% CI = 0.7\u20130.9) comparatively; Ob-I\/II encountered pneumonia less frequently (OR = 0.9; 95% CI = 0.4\u20130.9), whereas myocardial infarction was more frequent (OR = 7.0; 95% CI = 2.1\u201323.6) compared to N-Ob patients. Acute renal failure is more frequent in Ob-I\/II (OR = 1.2; 95% CI = 1.0\u20131.3) and Ob-III (OR = 1.8; 95% CI = 1.6\u20131.9) compared to the N-Ob cohort. LOS was higher in N-Ob (13.1 \u00b1 12.8 days) and Ob-III (13.5 \u00b1 12.4 d) compared to Ob-I\/II cohort (11.8 \u00b1 10.1 d; p &lt; 0.001). Mortality was 2.8%, 1.4%, and 2.9% (p &lt; 0.001) for N-Ob, Ob-I\/II, and Ob-III, respectively. Hospital charges were $22,025 higher in the Ob-III cohort. Ob-I\/II is protective against peri-operative complications and death, whereas hospital cost is substantially higher in Ob-III patients undergoing BKAs.<\/jats:p>","DOI":"10.3390\/jcm12010267","type":"journal-article","created":{"date-parts":[[2022,12,30]],"date-time":"2022-12-30T03:18:18Z","timestamp":1672370298000},"page":"267","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Morbidity and Mortality in Non-Obese Compared to Different Classes of Obesity in Patients Undergoing Transtibial Amputations"],"prefix":"10.3390","volume":"12","author":[{"given":"Senthil","family":"Sambandam","sequence":"first","affiliation":[{"name":"Department of Orthopedics, VA North Texas Health Care System, Dallas, TX 75216, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Syed Muhammad Mashhood Ali","family":"Bokhari","sequence":"additional","affiliation":[{"name":"Department of General Surgery, VA North Texas Health Care System, Dallas, TX 75216, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shirling","family":"Tsai","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, VA North Texas Health Care System, Dallas, TX 75216, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vishaal Sakthivel","family":"Nathan","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, VA North Texas Health Care System, Dallas, TX 75216, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tejas","family":"Senthil","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, VA North Texas Health Care System, Dallas, TX 75216, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Heather","family":"Lanier","sequence":"additional","affiliation":[{"name":"Department of General Surgery, VA North Texas Health Care System, Dallas, TX 75216, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sergio","family":"Huerta","sequence":"additional","affiliation":[{"name":"Department of General Surgery, VA North Texas Health Care System, Dallas, TX 75216, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,12,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Tsai, S., Lanier, H.D., Tran, N., Pham, T., and Huerta, S. 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Trauma Acute Care Surg."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/1\/267\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:55:09Z","timestamp":1760147709000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/1\/267"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,12,29]]},"references-count":20,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2023,1]]}},"alternative-id":["jcm12010267"],"URL":"https:\/\/doi.org\/10.3390\/jcm12010267","relation":{},"ISSN":["2077-0383"],"issn-type":[{"type":"electronic","value":"2077-0383"}],"subject":[],"published":{"date-parts":[[2022,12,29]]}}}