Malnutrition as predictor of poor outcome after total hip arthroplasty

Eminovic, Sandra; Vincze, Gábor; Eglseer, Doris; Riedl, Regina; Sadoghi, Patrick; Leithner, Andreas; Bernhardt, Gerwin A.

doi:10.1007/s00264-020-04892-4

Cited by 31 publications

(29 citation statements)

References 26 publications

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“…Whereas albumin had the highest specificity and a positive predictive value compared to all other markers such as total lymphocyte count and transferrin. Other studies have also confirmed the association of hypoalbuminemia with complications of arthroplasty from surgical site infection to pneumonia, cardiovascular pathology, and urinary tract infection [9,21,22,23]. Like the above reports, our findings showed low albumin and hemoglobin as the most prevalent (>50%) abnormal laboratory values.…”

Section: Discussionsupporting

confidence: 90%

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Protein-Energy Malnutrition as a Predictor of Early Recurrent Revisions After Debridement Surgery in Patients With Difficult-to-Treat Periprosthetic Infection

Божкова¹,

Ливенцов²,

Tikhilov³

et al. 2022

Traumatology and Orthopedics of Russia

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Background Protein energy malnutrition (PEM) is a proven risk factor of postoperative complications in orthopedic patients, including arthroplasty of the large joints. The aim of our study was the evaluation of PEM prevalence and its association with the early postoperative revision in patients with the difficult-to-treat (DTT) prosthetic joint infection (PJI) of the hip. Methods The retrospective study included 132 patients with chronic DTT PJI of the hip. The patients underwent the removal of the orthopedic implant, radical debridement of the infected tissues, and resection arthroplasty with non-free transplantation of an axial vastus lateralis muscle flap (n = 57) or installation of an antimicrobial spacer (n = 75). DTT PJI was defined as infection caused by rifampicin-resistant staphylococcal strains, ciprofloxacin-resistant gram-negative bacteria, fungi of the genus Candida, as well as their associations. Assessment of the patient's protein-energy status included the evaluation of the reference laboratory parameters: the levels of hemoglobin, total protein, albumin, and the number of lymphocytes. The degree of PEM was determined by the number of laboratory markers below the threshold values. The statistical comparison was performed using Fisher's test. The odds ratio (OR, 95% CI) was calculated to assess the risk of PJI recurrence. Differences were considered significant at p 0.05. Results More than 70% of patients with chronic DTT PJI included in the study were diagnosed with preoperative PEM of varying degree of severity. Hypoalbuminemia and a decrease in hemoglobin levels were diagnosed more often: 64.3 and 57.1% in the muscle flap plasty and 57.3 and 31.1% in the antimicrobial spacer group, respectively. In addition, in muscle plasty and antimicrobial spacer groups, a decrease of three or more reference PEM markers was detected in 28.5 and 16.0% of patients and this advanced impairment of the nutritional status increased the risk of early revision intervention by 2 (OR 2.0; CI 95% 0.47-8.56; p = 0.35) and 6 times (OR = 6.11; CI 95% 1.06-35.35; p 0.04), respectively. Conclusion In general, the analysis of publications and results of our study show that PEM is associated with the development of surgical site infection and recurrence of PJI after revision surgery. A decrease in three or more reference PEM markers is a significant predictor of repeated revisions after debridement surgery with the installation of an antimicrobial spacer. PEM complicates the course of postoperative period in patients with resection arthroplasty. Given the high incidence of PEM in patients with DTT PJI of the hip joint further research is needed to develop methods for nutritional status correction and assessment of their impact on the outcomes of debridement surgery.

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Section: Discussionsupporting

confidence: 90%

“…The average preoperative prevalence of PEM in patients undergoing arthroplasty depending on the heterogeneity of the cohort has been widely reported at 8.5%, 12.3%, 53% and 80% [13,15,15,20,21]. At the time of hospital admission, most of our patients (>70%) had laboratory signs of PEM.…”

Section: Discussionmentioning

confidence: 68%

Protein-Energy Malnutrition as a Predictor of Early Recurrent Revisions After Debridement Surgery in Patients With Difficult-to-Treat Periprosthetic Infection

Божкова¹,

Ливенцов²,

Tikhilov³

et al. 2022

Traumatology and Orthopedics of Russia

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“…It has been suggested that preoperative nutritional assessment in patients with CP sequela helps in improving the clinical condition of the patients (7). Malnutrition has been seen as a contributing factor to the development of postoperative complications due to suppressed immune system, delayed wound healing, and worsening of gastroesophageal reflux (8,9). The simplest method that can be used to evaluate the immune system status is to calculate the absolute lymphocyte count.…”

Section: Discussionmentioning

confidence: 99%

Factors Affecting Morbidity in Children With Cerebral Palsy Sequelae Who Underwent Corrective Osteotomy

Canbolat¹

2022

J Istanb Fac Med

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Objective: Cerebral palsy (CP) is a neurodevelopmental disease characterized by movement and posture disorders due to non-progressive damage. Femur varization-derotation osteotomy is a surgical procedure performed to correct femoral anteversion in patients with CP. The aim of this study is to determine the factors affecting morbidity in children with CP sequelae who underwent corrective osteotomy.

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“…Previous studies have confirmed that compared to older people with good nutritional status, those with undernutrition or high undernutrition risk show low immunity, poor resistance, decreased quality of life, prolonged hospital stay, increased hospital costs, poor treatment effect, poor prognosis, and high incidence of complications (6)(7)(8)(9). Numerous studies have demonstrated the association of undernutrition with a high incidence of and mortality due to fractures and various diseases in older individuals (10)(11)(12)(13)(14)(15). Therefore, considering the increasing proportion of older individuals in China, the "Healthy China 2030 Program Outline" and improvements in the nutritional status and health of all citizens in China need to be implemented.…”

Section: Introductionmentioning

confidence: 96%

Geographic and Age Variations in Low Body Mass Index Among Community-Dwelling Older People in Xinjiang: A Cross-Sectional Study

Liu

Qun²,

Xuekelati

et al. 2021

Front. Med.

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Background: Studies have shown an association between undernutrition and increased adverse outcome, as well as substantial geographic and age variations in undernutrition. Body mass index (BMI), a core indicator of undernutrition, is easy to measure and reflects the nutritional and health status of the human body. It is a simple and suitable tool for epidemiological investigations in large sample populations. Herein, we provide the first description of geographic and age variations in the prevalence of low BMI among community-dwelling older people in Xinjiang.Methods: From January 2019 to December 2019, using a multi-stage random sampling method, we conducted a cross-sectional epidemiological survey of the community-dwelling older people in Xinjiang at different latitudes. Of the 87,000 participants, the statistical analyses included 86,514 participants with complete data.Results: In Xinjiang, the prevalence of low BMI was 7.7% in the community-dwelling older people. The BMI gradually decreased with increasing age and gradually increased with latitude. The prevalence of low BMI in northern Xinjiang was 5.3%, which was significantly lower than that in eastern (7.7%) and southern (9.3%) Xinjiang. In the 60–69-, 70–79-, 80–89-, and ≥90-year age groups, the prevalence rates of low BMI were 5.8, 7.9, 10.0, and 13.9%, respectively. After adjusting for confounding factors (sex, ethnic group, hypertension, diabetes, hyperlipemia, smoking, and drinking), multivariate logistic regression analysis showed that the odds ratios (95% CI) for low BMI in eastern and southern Xinjiang were 1.165 (1.056–1.285) and 1.400 (1.274–1.538), respectively, compared to northern Xinjiang. The adjusted odds ratios (95% CI) for low BMI in the 70–79-, 80–89-, and ≥90-year age groups were 1.511 (1.39–1.635), 2.233 (2.030–2.456), and 3.003 (2.439–3.696), respectively, compared to the 60–69-year age group.Conclusion: The results of this study revealed geographic and age variations in the prevalence of low BMI in the community-dwelling older people in Xinjiang. The prevalence of low BMI gradually increased as the latitude decreased and as age increased.

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Malnutrition as predictor of poor outcome after total hip arthroplasty

Cited by 31 publications

References 26 publications

Protein-Energy Malnutrition as a Predictor of Early Recurrent Revisions After Debridement Surgery in Patients With Difficult-to-Treat Periprosthetic Infection

Protein-Energy Malnutrition as a Predictor of Early Recurrent Revisions After Debridement Surgery in Patients With Difficult-to-Treat Periprosthetic Infection

Factors Affecting Morbidity in Children With Cerebral Palsy Sequelae Who Underwent Corrective Osteotomy

Geographic and Age Variations in Low Body Mass Index Among Community-Dwelling Older People in Xinjiang: A Cross-Sectional Study

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