Relationship Between Preoperative Nutritional Status and Predicting Short-Term Complications Following Revision Total Hip Arthroplasty
The association between malnutrition and complications following primary total joint arthroplasty is well-delineated; however, nutritional status has yet to be explored specifically in revision total hip arthroplasty (THA). Therefore, our objective was to examine if a patient’s nutritional status ba...
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| Veröffentlicht in: | The Journal of arthroplasty 2023-07, Vol.38 (7), p.1326-1329 |
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| container_title | The Journal of arthroplasty |
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| creator | Heimroth, Jamie C. Neufeld, Eric V. Sodhi, Nipun Walden, Timothy Willinger, Max L. Boraiah, Sreevathsa |
| description | The association between malnutrition and complications following primary total joint arthroplasty is well-delineated; however, nutritional status has yet to be explored specifically in revision total hip arthroplasty (THA). Therefore, our objective was to examine if a patient’s nutritional status based on body mass index, diabetic status, and serum albumin predicted complications following a revision THA.
A retrospective national database review identified 12,249 patients who underwent revision THA from 2006 to 2019. Patients were stratified based on body mass index ( |
| doi_str_mv | 10.1016/j.arth.2023.02.077 |
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A retrospective national database review identified 12,249 patients who underwent revision THA from 2006 to 2019. Patients were stratified based on body mass index (<18.5 = underweight, 18.5-29.9 = healthy/overweight, ≥30 = obese), diagnosis of diabetes (no diabetes, insulin-dependent diabetes mellitus (IDDM), non-insulin-dependent diabetes mellitus), and preoperative serum albumin (<3.5 = malnourished, ≥3.5 = non-malnourished). Multivariate analyses were performed using chi-square tests and multiple logistic regressions.
In all groups including underweight (1.8%), healthy/overweight (53.7%), and obese (44.5%), those without diabetes were less likely to be malnourished (P < .001), while those with IDDM had a higher rate of malnutrition (P < .001). Underweight patients were significantly more malnourished compared to healthy/overweight or obese patients (P < .05). Malnourished patients had an increased risk of wound dehiscence/surgical site infections (P < .001), urinary tract infection (P < .001), requiring a blood transfusion (P < .001), sepsis (P < .001), and septic shock (P < .001). Malnourished patients also have worse postoperative pulmonary and renal function.
Patients who are underweight or have IDDM are more likely to be malnourished. The risk of complications within 30 days of surgery following revision THA significantly increases with malnutrition. This study shows the utility of screening underweight and IDDM patients for malnutrition prior to revision THA to minimize complications.]]></description><identifier>ISSN: 0883-5403</identifier><identifier>EISSN: 1532-8406</identifier><identifier>DOI: 10.1016/j.arth.2023.02.077</identifier><identifier>PMID: 36878436</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>albumin ; Arthroplasty, Replacement, Hip - adverse effects ; diabetes mellitus ; Diabetes Mellitus, Type 1 - complications ; Humans ; insulin ; malnutrition ; Malnutrition - complications ; Malnutrition - diagnosis ; Malnutrition - epidemiology ; Nutritional Status ; Obesity - complications ; Overweight - complications ; Postoperative Complications - epidemiology ; Postoperative Complications - etiology ; Reoperation - adverse effects ; Retrospective Studies ; revision ; Risk Factors ; Thinness - complications ; Thinness - epidemiology ; total hip arthroplasty</subject><ispartof>The Journal of arthroplasty, 2023-07, Vol.38 (7), p.1326-1329</ispartof><rights>2023</rights><rights>Copyright © 2023. Published by Elsevier Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c356t-9111ea3044a091cb7e01cd8fe9c590c2064e3ae70ba832350edf6e3967b6ae1f3</citedby><cites>FETCH-LOGICAL-c356t-9111ea3044a091cb7e01cd8fe9c590c2064e3ae70ba832350edf6e3967b6ae1f3</cites><orcidid>0000-0003-2804-573X ; 0000-0002-4475-5857 ; 0000-0002-7247-7671</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.arth.2023.02.077$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3548,27923,27924,45994</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36878436$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Heimroth, Jamie C.</creatorcontrib><creatorcontrib>Neufeld, Eric V.</creatorcontrib><creatorcontrib>Sodhi, Nipun</creatorcontrib><creatorcontrib>Walden, Timothy</creatorcontrib><creatorcontrib>Willinger, Max L.</creatorcontrib><creatorcontrib>Boraiah, Sreevathsa</creatorcontrib><title>Relationship Between Preoperative Nutritional Status and Predicting Short-Term Complications Following Revision Total Hip Arthroplasty</title><title>The Journal of arthroplasty</title><addtitle>J Arthroplasty</addtitle><description><![CDATA[The association between malnutrition and complications following primary total joint arthroplasty is well-delineated; however, nutritional status has yet to be explored specifically in revision total hip arthroplasty (THA). Therefore, our objective was to examine if a patient’s nutritional status based on body mass index, diabetic status, and serum albumin predicted complications following a revision THA.
A retrospective national database review identified 12,249 patients who underwent revision THA from 2006 to 2019. Patients were stratified based on body mass index (<18.5 = underweight, 18.5-29.9 = healthy/overweight, ≥30 = obese), diagnosis of diabetes (no diabetes, insulin-dependent diabetes mellitus (IDDM), non-insulin-dependent diabetes mellitus), and preoperative serum albumin (<3.5 = malnourished, ≥3.5 = non-malnourished). Multivariate analyses were performed using chi-square tests and multiple logistic regressions.
In all groups including underweight (1.8%), healthy/overweight (53.7%), and obese (44.5%), those without diabetes were less likely to be malnourished (P < .001), while those with IDDM had a higher rate of malnutrition (P < .001). Underweight patients were significantly more malnourished compared to healthy/overweight or obese patients (P < .05). Malnourished patients had an increased risk of wound dehiscence/surgical site infections (P < .001), urinary tract infection (P < .001), requiring a blood transfusion (P < .001), sepsis (P < .001), and septic shock (P < .001). Malnourished patients also have worse postoperative pulmonary and renal function.
Patients who are underweight or have IDDM are more likely to be malnourished. The risk of complications within 30 days of surgery following revision THA significantly increases with malnutrition. This study shows the utility of screening underweight and IDDM patients for malnutrition prior to revision THA to minimize complications.]]></description><subject>albumin</subject><subject>Arthroplasty, Replacement, Hip - adverse effects</subject><subject>diabetes mellitus</subject><subject>Diabetes Mellitus, Type 1 - complications</subject><subject>Humans</subject><subject>insulin</subject><subject>malnutrition</subject><subject>Malnutrition - complications</subject><subject>Malnutrition - diagnosis</subject><subject>Malnutrition - epidemiology</subject><subject>Nutritional Status</subject><subject>Obesity - complications</subject><subject>Overweight - complications</subject><subject>Postoperative Complications - epidemiology</subject><subject>Postoperative Complications - etiology</subject><subject>Reoperation - adverse effects</subject><subject>Retrospective Studies</subject><subject>revision</subject><subject>Risk Factors</subject><subject>Thinness - complications</subject><subject>Thinness - epidemiology</subject><subject>total hip arthroplasty</subject><issn>0883-5403</issn><issn>1532-8406</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kEFu3CAUQFHVqpmkvUAXlZfd2P2AjbHUTTpKmkhREiXTNWLwd4eRbVzAE-UCPXexJu0yKyR4_wGPkE8UCgpUfN0X2sddwYDxAlgBdf2GrGjFWS5LEG_JCqTkeVUCPyGnIewBKK2q8j054ULWsuRiRf48YK-jdWPY2Sn7jvEJcczuPboJfTo4YHY7R28XRPfZY9RxDpke24VprYl2_JU97pyP-Qb9kK3dMPXWHJXZpet797QgD3iwIe1lGxeT5ypddp4e793U6xCfP5B3ne4DfnxZz8jPy4vN-iq_uftxvT6_yQ2vRMwbSilqDmWpoaFmWyNQ08oOG1M1YBiIErnGGrZacsYrwLYTyBtRb4VG2vEz8uXonbz7PWOIarDBYN_rEd0cFFuyyFKyMqHsiBrvQvDYqcnbQftnRUEt_dVeLf3V0l8BU6l_Gvr84p-3A7b_R_4FT8C3I4DplweLXgVjcTSppUcTVevsa_6_RMGaQQ</recordid><startdate>202307</startdate><enddate>202307</enddate><creator>Heimroth, Jamie C.</creator><creator>Neufeld, Eric V.</creator><creator>Sodhi, Nipun</creator><creator>Walden, Timothy</creator><creator>Willinger, Max L.</creator><creator>Boraiah, Sreevathsa</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-2804-573X</orcidid><orcidid>https://orcid.org/0000-0002-4475-5857</orcidid><orcidid>https://orcid.org/0000-0002-7247-7671</orcidid></search><sort><creationdate>202307</creationdate><title>Relationship Between Preoperative Nutritional Status and Predicting Short-Term Complications Following Revision Total Hip Arthroplasty</title><author>Heimroth, Jamie C. ; Neufeld, Eric V. ; Sodhi, Nipun ; Walden, Timothy ; Willinger, Max L. ; Boraiah, Sreevathsa</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c356t-9111ea3044a091cb7e01cd8fe9c590c2064e3ae70ba832350edf6e3967b6ae1f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>albumin</topic><topic>Arthroplasty, Replacement, Hip - adverse effects</topic><topic>diabetes mellitus</topic><topic>Diabetes Mellitus, Type 1 - complications</topic><topic>Humans</topic><topic>insulin</topic><topic>malnutrition</topic><topic>Malnutrition - complications</topic><topic>Malnutrition - diagnosis</topic><topic>Malnutrition - epidemiology</topic><topic>Nutritional Status</topic><topic>Obesity - complications</topic><topic>Overweight - complications</topic><topic>Postoperative Complications - epidemiology</topic><topic>Postoperative Complications - etiology</topic><topic>Reoperation - adverse effects</topic><topic>Retrospective Studies</topic><topic>revision</topic><topic>Risk Factors</topic><topic>Thinness - complications</topic><topic>Thinness - epidemiology</topic><topic>total hip arthroplasty</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Heimroth, Jamie C.</creatorcontrib><creatorcontrib>Neufeld, Eric V.</creatorcontrib><creatorcontrib>Sodhi, Nipun</creatorcontrib><creatorcontrib>Walden, Timothy</creatorcontrib><creatorcontrib>Willinger, Max L.</creatorcontrib><creatorcontrib>Boraiah, Sreevathsa</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Journal of arthroplasty</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Heimroth, Jamie C.</au><au>Neufeld, Eric V.</au><au>Sodhi, Nipun</au><au>Walden, Timothy</au><au>Willinger, Max L.</au><au>Boraiah, Sreevathsa</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Relationship Between Preoperative Nutritional Status and Predicting Short-Term Complications Following Revision Total Hip Arthroplasty</atitle><jtitle>The Journal of arthroplasty</jtitle><addtitle>J Arthroplasty</addtitle><date>2023-07</date><risdate>2023</risdate><volume>38</volume><issue>7</issue><spage>1326</spage><epage>1329</epage><pages>1326-1329</pages><issn>0883-5403</issn><eissn>1532-8406</eissn><abstract><![CDATA[The association between malnutrition and complications following primary total joint arthroplasty is well-delineated; however, nutritional status has yet to be explored specifically in revision total hip arthroplasty (THA). Therefore, our objective was to examine if a patient’s nutritional status based on body mass index, diabetic status, and serum albumin predicted complications following a revision THA.
A retrospective national database review identified 12,249 patients who underwent revision THA from 2006 to 2019. Patients were stratified based on body mass index (<18.5 = underweight, 18.5-29.9 = healthy/overweight, ≥30 = obese), diagnosis of diabetes (no diabetes, insulin-dependent diabetes mellitus (IDDM), non-insulin-dependent diabetes mellitus), and preoperative serum albumin (<3.5 = malnourished, ≥3.5 = non-malnourished). Multivariate analyses were performed using chi-square tests and multiple logistic regressions.
In all groups including underweight (1.8%), healthy/overweight (53.7%), and obese (44.5%), those without diabetes were less likely to be malnourished (P < .001), while those with IDDM had a higher rate of malnutrition (P < .001). Underweight patients were significantly more malnourished compared to healthy/overweight or obese patients (P < .05). Malnourished patients had an increased risk of wound dehiscence/surgical site infections (P < .001), urinary tract infection (P < .001), requiring a blood transfusion (P < .001), sepsis (P < .001), and septic shock (P < .001). Malnourished patients also have worse postoperative pulmonary and renal function.
Patients who are underweight or have IDDM are more likely to be malnourished. The risk of complications within 30 days of surgery following revision THA significantly increases with malnutrition. This study shows the utility of screening underweight and IDDM patients for malnutrition prior to revision THA to minimize complications.]]></abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>36878436</pmid><doi>10.1016/j.arth.2023.02.077</doi><tpages>4</tpages><orcidid>https://orcid.org/0000-0003-2804-573X</orcidid><orcidid>https://orcid.org/0000-0002-4475-5857</orcidid><orcidid>https://orcid.org/0000-0002-7247-7671</orcidid></addata></record> |
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| source | MEDLINE; ScienceDirect Journals (5 years ago - present) |
| subjects | albumin Arthroplasty, Replacement, Hip - adverse effects diabetes mellitus Diabetes Mellitus, Type 1 - complications Humans insulin malnutrition Malnutrition - complications Malnutrition - diagnosis Malnutrition - epidemiology Nutritional Status Obesity - complications Overweight - complications Postoperative Complications - epidemiology Postoperative Complications - etiology Reoperation - adverse effects Retrospective Studies revision Risk Factors Thinness - complications Thinness - epidemiology total hip arthroplasty |
| title | Relationship Between Preoperative Nutritional Status and Predicting Short-Term Complications Following Revision Total Hip Arthroplasty |
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