Value of lymphocyte counts as a prognostic index of survival following femoral neck fractures

Conlan, David P.

doi:10.1016/0020-1383(89)90012-0

Cited by 10 publications

(5 citation statements)

References 6 publications

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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%

“…Suboptimal nutrition was defined as a serum ALB level of <3.5 g/dl and a TLC of <1.50 cells/mm. 10,12,13,15 Data were tested for normality, and nonparametric tests were used owing to the skewed data. Patients with and without nutritional depletion were compared in term of their length of hospital stay and complications.…”

Section: Methodsmentioning

confidence: 99%

“…pressure sores), prolonged recovery, and increased mortality. [10][11][12][13] Haematological markers such as visceral proteins, namely serum albumin (ALB) level, total lymphocyte count (TLC), and transferrin are indicators of nutritional status. 10,14 It has been estimated that approximately 60% of patients with a hip fracture are malnourished based on such haematological parameters.…”

Section: Introductionmentioning

confidence: 99%

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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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Section: Discussionmentioning

confidence: 98%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Nutritional Status and Short-Term Outcome of Hip Arthroplasty

Nicholson

Dowrick

Liew

2012

J Orthop Surg (Hong Kong)

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“…Hand searching of included articles and published systematic reviews identified one further article meeting our inclusion criteria. 21 In total, eight studies published between 1979 and 2019 were included for meta-analysis. 2,3,21e26 The study flow diagram including reasons for exclusion is presented according to PRISMA guidelines (Fig.…”

Section: Study Selectionmentioning

confidence: 99%

“…4). 21,22,25 Subgroup analysis for this outcome was not possible because of the small number of studies.…”

Section: Primary Outcome: Lymphopaenia and Mortalitymentioning

confidence: 99%

Preoperative lymphopaenia, mortality, and morbidity after elective surgery: systematic review and meta-analysis

Schroth¹,

Weber²,

Jones³

et al. 2021

British Journal of Anaesthesia

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Background: In the general adult population, lymphopaenia is associated with an increased risk for hospitalisation with infection and infection-related death. The quality of evidence and strength of association between perioperative lymphopaenia across different surgical procedures and mortality/morbidity has not been examined by systematic review or meta-analysis. Methods: We searched MEDLINE, Embase, Web of Science, Google Scholar, and Cochrane databases from their inception to June 29, 2020 for observational studies reporting lymphocyte count and in-hospital mortality rate in adults. We defined preoperative lymphopaenia as a lymphocyte count 1.0e1.5Â10 9 L À1 . Meta-analysis was performed using either fixed or random effects models. Quality was assessed using the NewcastleeOttawa Scale. The I 2 index was used to quantify heterogeneity. The primary outcome was in-hospital mortality rate and mortality rate at 30 days. Results: Eight studies met the inclusion criteria for meta-analysis, comprising 4811 patients (age range, 46e91 yr; female, 20e79%). These studies examined preoperative lymphocyte count exclusively. Studies were of moderate to high quality overall, ranking >7 using the NewcastleeOttawa Scale. Preoperative lymphopaenia was associated with a threefold increase in mortality rate (risk ratio [RR]¼3.22; 95% confidence interval [CI], 2.19e4.72; P<0.01, I 2 ¼0%) and more frequent major postoperative complications (RR¼1.33; 95% CI, 1.21e1.45; P<0.01, I 2 ¼6%), including cardiovascular morbidity (RR¼1.77; 95% CI, 1.45e2.15; P<0.01, I 2 ¼0%), infections (RR¼1.45; 95% CI, 1.19e1.76; P<0.01, I 2 ¼0%), and acute renal dysfunction (RR¼2.66; 95% CI, 1.49e4.77; P<0.01, I 2 ¼1%). Conclusion: Preoperative lymphopaenia is associated with death and complications more frequently, independent of the type of surgery. Prospero registry number: CRD42020190702.

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Osteoporosis, Nutrition, and the Immune System

Monaco¹

2004

Diet and Human Immune Function

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Value of lymphocyte counts as a prognostic index of survival following femoral neck fractures

Cited by 10 publications

References 6 publications

Nutritional Status and Short-Term Outcome of Hip Arthroplasty

Nutritional Status and Short-Term Outcome of Hip Arthroplasty

Preoperative lymphopaenia, mortality, and morbidity after elective surgery: systematic review and meta-analysis

Osteoporosis, Nutrition, and the Immune System

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