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Nutritional status and short-term outcome of hip arthroplasty.
MedLine Citation:
PMID:  23255640     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
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. RESULTS. 86% of trauma patients and 30% of 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 trauma-related 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.
Authors:
J A Nicholson; A S Dowrick; S M Liew
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of orthopaedic surgery (Hong Kong)     Volume:  20     ISSN:  1022-5536     ISO Abbreviation:  J Orthop Surg (Hong Kong)     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-12-20     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9440382     Medline TA:  J Orthop Surg (Hong Kong)     Country:  China    
Other Details:
Languages:  eng     Pagination:  331-5     Citation Subset:  IM    
Affiliation:
Department of Orthopaedic Surgery, The Alfred, Melbourne, Victoria, Australia.
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