Retrospective cohort study finds higher 3-month adverse outcomes following orthopedic surgery in youth with eating disorders, highlighting elevated risks of postoperative infection.
Key Points
To evaluate the incidence of 3-month adverse postoperative complications among youth aged 21 years or younger with eating disorders compared to those without eating disorders undergoing common orthopedic procedures.
Conducted a retrospective cohort study using IBM MarketScan Medicaid and Commercial Databases (January 2016 to December 2022) analyzing youth ≤21 years undergoing spine, arthroscopy, or fracture surgeries.
Tracked adverse outcomes up to 3 months post-surgery, including infection, wound, systemic, and hardware complications, comparing 1,057 youth with eating disorders against 170,582 youth without eating disorders.
Calculated incidence rates (IR) per 100 person-years, incidence rate ratios (IRR), and Cox regression hazard ratios adjusted for age, sex, surgical type, and insurance coverage.
Youth with eating disorders experienced an 88% higher overall 5-outcome complication rate (IR 15.2, 95% CI=10.4–19.9 vs unexposed; IRR=1.88, 95% CI=1.37–2.58) and a 72% higher rate of non-infection complications (IR 11.2, 95% CI=7.1–15.3; IRR=1.72, 95% CI=1.19–2.48).
Procedure-related infection rates were 129% higher in the eating disorder cohort (IR 5.4, 95% CI=2.6–8.2; IRR=2.29, 95% CI=1.35–3.88).
Infection risk showed significant effect modification by age beyond 12 years, rising to an IRR of 1.87 (95% CI=1.04–3.38) by age 16 and 3.10 (95% CI=1.73–5.57) by age 19.