Preoperative Nutritional Status and Outcome of Elective Total Hip Replacement

Savio, Giuseppina; Zelicof, Steven B.; Wexler, L; Byrne, Daniel W.; Reddy, P D; Fish, Durland; Ende, K A

doi:10.1097/00003086-199605000-00018

Cited by 79 publications

(41 citation statements)

References 20 publications

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“…Malnourished patients also had significantly longer hospital stays which is consistent with historical data [6,8,13,18,30]. The overall rate of infection lower in this study compared to historical reports of malnourished patients [6][7][8]18].…”

Section: Discussionsupporting

confidence: 89%

“…The overall rate of infection lower in this study compared to historical reports of malnourished patients [6][7][8]18]. …”

Section: Discussionmentioning

confidence: 55%

“…Laboratory values which indicate nutritional insufficiency may be used as a screening tool for preoperative nutritional status [2,6,9,18]. The determination of the most appropriate tests in specific patients is poorly defined [19][20][21][22][23][24][25][26].…”

Section: Introductionmentioning

confidence: 99%

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The Effect of Malnutrition on Patients Undergoing Elective Joint Arthroplasty

Huang

Greenky

Kerr

et al. 2013

The Journal of Arthroplasty

159

141

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Section: Discussionsupporting

confidence: 89%

“…The overall rate of infection lower in this study compared to historical reports of malnourished patients [6][7][8]18]. …”

Section: Discussionmentioning

confidence: 55%

See 1 more Smart Citation

The Effect of Malnutrition on Patients Undergoing Elective Joint Arthroplasty

Huang

Greenky

Kerr

et al. 2013

The Journal of Arthroplasty

159

141

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“…10 Malnourished patients undergoing hip arthroplasty are prone to having increased rates of wound infections, delayed healing, prolonged hospital stay, and all-cause, one-year mortality. 10,13,15,17 In malnourished patients, mortality associated with a hip fracture is estimated to be 5 to 10% at one month and 33% at one year, which is higher than the expected annual mortality of about 10%. 1 The serum ALB level and TLC are valid and reliable markers for identifying malnourished patients.…”

Section: Discussionmentioning

confidence: 98%

Nutritional Status and Short-Term Outcome of Hip Arthroplasty

Nicholson

Dowrick

Liew

2012

J Orthop Surg (Hong Kong)

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purpose. To review nutritional status and outcome of 90 patients who underwent total hip arthroplasty (THA) or hemiarthroplasty. Methods. Records of 51 women and 39 men aged 26 to 96 (median, 71) years who underwent elective THA (n=48) for osteoarthritis, or trauma-related THA (n=10) or hemiarthroplasty (n=32) for subcapital femoral neck fractures using an uncemented femoral stem were retrospectively reviewed. Patient demographics and intra-and post-operative complications were recorded. Patient co-morbidities were assessed according to the Charlson grading system. Nutritional status was assessed using haematological markers of serum albumin (ALB) level and total lymphocyte count (TLC). Samples were taken on the day of the operation and within 24 hours of operation. Suboptimal nutrition was defined as a serum ALB level of <3.5 g/dl and a TLC of <1.50 cells/mm. elective patients were malnourished preoperatively (p<0.001). Preoperatively, more males than females had suboptimal ALB levels (28% vs. 8%, p=0.033) and TLC (82% vs. 31%, p<0.001). Age was inversely proportional to preoperative ALB and TLC values; patients older than 75 years had significantly lower values. Of those staying >7 days in hospital, 67% were aged >75 years as opposed to 31% were aged ≤75 years (p=0.001). Male gender, old age, and presentation with trauma were risk factors for suboptimal nutritional parameters (p<0.001 for all). Patients with suboptimal ALB and TLC values had a significantly longer stay in hospital (p=0.032 and p=0.021, respectively). conclusion. The rate of malnourishment was significantly higher in patients having traumarelated surgery than in those having elective surgery. Malnourished patients are at greater risk of prolonged hospital stay. Preoperative nutritional assessment may be useful in predicting patients at high surgical risk.

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“…4,10 Albumin and transferrin are both biochemical markers of nutrition; low levels have been found to be predictors of longer recovery times and longer hospital stays. 4,11 Triceps skinfold is an anthropometric parameter of nutrition that has an inversely proportional relationship with postoperative infection risk after TKR. 12 Low body mass index in the elderly was found to increase LOS following TKR.…”

Section: Preoperative Nutritionmentioning

confidence: 99%

An evidence-based review of enhanced recovery interventions in knee replacement surgery

Ibrahim

Alazzawi

Nizam

et al. 2013

annals

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Introduction Total knee replacement (TKR) is a very common surgical procedure. Improved pain management techniques, surgical practices and the introduction of novel interventions have enhanced the patient’s postoperative experience after TKR. Safe, efficient pathways are needed to address the increasing need for knee arthroplasty in the UK. Enhanced recovery programmes can help to reduce hospital stays following knee replacements while maintaining patient safety and satisfaction. This review outlines common evidence-based pre, intra and postoperative interventions in use in enhanced recovery protocols following TKR. Methods A thorough literature search of the electronic healthcare databases (MEDLINE®, Embase™ and the Cochrane Library) was conducted to identify articles and studies concerned with enhanced recovery and fast track pathways for TKR. Results A literature review revealed several non-operative and operative interventions that are effective in enhanced recovery following TKR including preoperative patient education, pre-emptive and local infiltration analgesia, preoperative nutrition, neuromuscular electrical stimulation, pulsed electromagnetic fields, perioperative rehabilitation, modern wound dressings, different standard surgical techniques, minimally invasive surgery and computer assisted surgery. Conclusions Enhanced recovery programmes require a multidisciplinary team of dedicated professionals, principally involving preoperative education, multimodal pain control and accelerated rehabilitation; this will be boosted if combined with minimally invasive surgery. The current economic climate and restricted healthcare budget further necessitate brief hospitalisation while minimising costs. These non-operative interventions are the way forward to achieve such requirements.

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Preoperative Nutritional Status and Outcome of Elective Total Hip Replacement

Cited by 79 publications

References 20 publications

The Effect of Malnutrition on Patients Undergoing Elective Joint Arthroplasty

The Effect of Malnutrition on Patients Undergoing Elective Joint Arthroplasty

Nutritional Status and Short-Term Outcome of Hip Arthroplasty

An evidence-based review of enhanced recovery interventions in knee replacement surgery

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