Impact of Different Body Mass Index Cutoff Points on Complication Rates Following Primary Total Ankle Replacement

Introduction This study evaluates the impact of implementing body mass index (BMI) cutoff points on 6-month postoperative outcomes following total ankle replacement (TAR). Methods The Nationwide Readmissions Database (NRD) was queried from 2015 to 2020 to identify 5865 patients undergoing primary elective TAR, stratified into groups by 5 BMI point intervals. Preoperative demographics, comorbidities, postoperative outcomes, and total length of stay (LOS) were analyzed between cohorts, with additional multivariate regression analyses conducted to control for predictors other than BMI. Results Multivariate regression analysis of 180-day postoperative outcomes found that preoperative BMI of 40 to 44.9 and ≥45 kg/m 2 was significantly predictive of increased risk of overall complication, adverse discharge, and LOS greater than 4 days. Conclusion A BMI above 40 kg/m 2 is associated with a significantly increased risk of complications (odds ratio [OR] = 1.960; P < .001), adverse discharge (OR = 2.030; P < .001), and extended LOS (OR = 2.171; P < .001).