The Effect of Malnutrition on Patients Undergoing Elective Joint Arthroplasty

Comorbidities in Patients Undergoing Total Knee Arthroplasty: Do They Influence Hospital Costs and Length of Stay?

“…These findings corroborate a recent Mayo Clinic study that found obesity (and every five-unit BMI increase over 30 kg/m 2 ) increased hospital costs USD 500 and 90-day costs by USD 900 after THA [23]. Furthermore, the most costly comorbidities have been previously implicated as independent risk factors for complication after arthroplasty [3,16,22,26]. The cause of higher costs in these multiply comorbid patients is likely multifactorial.…”

Hypoalbuminemia Is a Better Predictor than Obesity of Complications After Total Knee Arthroplasty: a Propensity Score-Adjusted Observational Analysis

“…While albumin, lymphocyte count, and transferrin are all useful markers of nutritional status [9], it is difficult to compare prevalence rates between studies with different definitions of malnutrition. However, despite varying definitions in the orthopedic literature, malnutrition has been associated with prosthetic joint infections as well as persistent wound drainage, hematoma formation, infection, renal complications, and cardiac complications postoperatively [19,20]. Consistent with prior published literature, our multivariable regression models found preoperative a Each line represents a separate multivariable logistic regression to give an adjusted odds ratio and p value while controlling for patient characteristics and propensity score.…”

“…There is a paucity of studies that have examined nutritional status and obesity concurrently in TKA patients. In the study by Huang et al [20], the authors found that 9% of patients with BMI 20 to 29.9 kg/m 2 were malnourished, 7.7% were malnourished in the BMI 30 to 39.9 kg/m 2 group, and 7.8% in the BMI ≥40 kg/m 2 group. They did not find any statistically significant differences in the distribution of various BMI classes between malnourished and nonmalnourished patients, though their BMI groups were defined differently than our current study.…”

“…In a consecutive series of 217 patients undergoing primary TKA or THA, Greene et al [19] found four patients (1.8%) with hypoalbuminemia, and 57 patients had a lymphocyte count of less than 1500 cells/mm 3 (another commonly used marker of malnutrition). Similarly, in a prospective study of 2161 patients undergoing TKA or THA, Huang et al [20] found that 8.5% of their cohort was malnourished, defined as either serum albumin <3.5 g/dL or serum transferrin <200 mg/dL. Of their malnourished cohort, however, 72.8% of patients had a normal albumin and low transferrin.…”

CORR Insights®: Is Potential Malnutrition Associated With Septic Failure and Acute Infection After Revision Total Joint Arthroplasty?

“…Our ability to accurately identify high-risk PJI patients will improve if we can demonstrate a causative link with malnutrition. As already mentioned in the current study, work for such clinical research is reportedly at the implementation stage [2]. This type of study will require multicenter, prospective study designs, with standardized protocols for malnutrition screening and subsequent correction, as well as sufficient funding and personnel.…”