Role of obesity in orthopedic surgical outcomes and complications: A retrospective cohort study at King Fahad University Hospital

doi:10.5312/wjo.121847

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World Journal of Orthopedics

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2218-5836

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Retrospective Cohort Study

Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Orthop. Jul 18, 2026; 17(7): 121847
Published online Jul 18, 2026. doi: 10.5312/wjo.121847

Table 1 Baseline characteristics of study participants by obesity status, mean ± SD/n (%)

Variable		Non-obese (n = 184)	Obese (n = 184)	Total (n = 368)	P value
Age (years)		41.0 ± 16.3	50.3 ± 17.1	45.7 ± 17.3	< 0.001
Gender	Male	126 (68.5)	77 (41.8)	203 (100)	< 0.001
Gender	Female	58 (31.5)	107 (58.2)	165 (100)	< 0.001
Diabetes mellitus	Yes	27 (37)	46 (63)	73 (100)	0.013
Diabetes mellitus	No	157 (53.2)	138 (46.8)	295 (100)	0.013
Hypertension	Yes	27 (30.7)	61 (69.3)	88 (100)	< 0.001
Hypertension	No	157 (56.1)	123 (43.9)	280 (100)	< 0.001
Dyslipidemia	Yes	10 (33.3)	20 (66.7)	30 (100)	0.057
Dyslipidemia	No	174 (51.5)	164 (48.5)	338 (100)	0.057
Hypothroidism	Yes	4 (26.7)	11 (73.3)	15 (100)	0.065
Hypothroidism	No	180 (51)	173 (49)	353 (100)	0.065
Smoking status	Yes	12 (6.5)	21 (11.4)	33 (100)	0.144
Smoking status	No	172 (93.5)	163 (88.6)	335 (100)	0.144

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Table 2 Post-orthopedic surgical outcomes and complications by obesity status, n (%)

Outcome	Category	Non-obese	Obese	Total	P value
Surgical outcome	Complications	12 (20.0)	48 (80.0)	60 (100)	< 0.001
Surgical outcome	Successful	172 (55.8)	136 (44.2)	308 (100)	< 0.001
Thromboembolism	No	182 (51.1)	174 (48.9)	356 (100)	0.019
Thromboembolism	Yes	2 (16.7)	10 (83.3)	12 (100)	0.019
Prosthesis loosening/failure	No	183 (51.0)	176 (49.0)	359 (100)	0.018
Prosthesis loosening/failure	Yes	1 (11.1)	8 (88.9)	9 (100)	0.018
Fracture non-union/malunion	No	183 (51.1)	175 (48.9)	358 (100)	0.010
Fracture non-union/malunion	Yes	1 (10.0)	9 (90.0)	10 (100)	0.010
Nerve injury	No	182 (52.0)	168 (48.0)	350 (100)	0.001
Nerve injury	Yes	2 (11.1)	16 (88.9)	18 (100)	0.001
Post-surgical infection	No	178 (51.6)	167 (48.4)	345 (100)	0.018
Post-surgical infection	Yes	6 (26.1)	17 (73.9)	23 (100)	0.018

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Table 3 Postoperative outcomes by obesity status, mean ± SD/n (%)

Variables		Non-obese	Obese	P value
Length of hospital stay (days)		3.23 ± 2.94	5.85 ± 9.03	< 0.001
Pain score (VAS 0-10)		3.32 ± 2.62	4.13 ± 2.27	0.002
Mobility score (post-surgery)	Limited	33 (36.7)	57 (63.3)	0.014
	Moderate	68 (53.1)	60 (46.9)
	Normal	83 (55.3)	67 (44.7)
Reoperation	No	174 (52.1)	160 (47.9)	0.012
Reoperation	Yes	10 (29.4)	24 (70.6)	0.012

VAS: Visual Analog Scale.

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Table 4 Multivariable logistic regression for predictive factors for successful surgical outcome

Dependent variable: Successful surgery (predictor)	Adjusted OR	95%CI for OR	P value
Age > 50 years	1.41	1.05-1.89	0.127
Gender (female vs male)	1.71	0.75-3.75	0.291
Obesity status (non-obese vs obese)	2.61	1.29-4.72	0.019
Length of hospital stay (days)	0.87	0.57-1.24	0.032
Smoking (no vs yes)	0.59	0.17-2.23	0.452
Diabetes mellitus (no vs yes)	1.08	0.28-4.15	0.926
Hypertension (no vs yes)	0.44	0.13-1.50	0.212
Thromboembolism (no vs yes)	-	-	-¹
Post-surgical infection (no vs yes)	-	-	-¹
Pain score (VAS 0-10)	1.12	0.81-1.98	0.271

¹Very low event count (unstable estimates).

OR: Odds ratio; VAS: Visual Analog Scale.

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Citation: Alomran AK, Alhaddad S, Alqahtani Y, Bahri Y, Alyami M, Alzawad A, Algurashi W, Khouqeer A, Alhumluji A. Role of obesity in orthopedic surgical outcomes and complications: A retrospective cohort study at King Fahad University Hospital. World J Orthop 2026; 17(7): 121847
URL: https://www.wjgnet.com/2218-5836/full/v17/i7/121847.htm
DOI: https://dx.doi.org/10.5312/wjo.121847

Alomran AK, Alhaddad S, Alqahtani Y, Bahri Y, Alyami M, Alzawad A, Algurashi W, Khouqeer A, Alhumluji A. Role of obesity in orthopedic surgical outcomes and complications: A retrospective cohort study at King Fahad University Hospital. World J Orthop 2026; 17(7): 121847 [DOI: 10.5312/wjo.121847]

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