Abstract
IntroductionThe aim of this study was to assess the prevalence of protein energy malnutrition (PEM) and correlation with poor post-operative outcome in the elderly undergoing primary total hip arthroplasty (THA).HypothesisPatients with PEM would have inferior post-operative outcome after THA.Materials and methodWe retrospectively evaluated the nutritional status of 220 hospitalized patients undergoing THA, 65 years and older. PEM was assessed using serum albumin and total lymphocyte count (TLC). Studied outcome parameters were length of pre-operative and post-operative stay, complications up to six months after surgery and 12-month mortality. Clinical and demographic data were retrieved from medical records from the hospital database.ResultsThe prevalence of PEM among patients undergoing THA was 12.3% (27/220). Patients with PEM were significantly older (mean age 81.3 ± 7.0, p < 0.001), had a lower BMI (24.7 ± 4.1 kg/m 2, p = 0.022), and showed more comorbid conditions (mean CCI 2.8 ± 2.0, p = 0.002) compared with well-nourished patients (age 75.6 ± 6.2, BMI 26.8 ± 4.3 kg/m 2, CCI: 1.7 ± 1.7). Length of pre-operative stay differed significantly (p < 0.001) between PEM (median 7, range 1–36 days) and non PEM (median 1, range 1–22 days). In the PEM group, 12 (44.4%) patients had post-operative complications within six months after OP and 15 (7.8%) patients in the non PEM group (HR = 6.3, 95% CI 1.7–23.1).ConclusionWe observed a higher post-operative complication rate for malnourished patients undergoing elective THA. These results underline the importance of pre-operative nutritional assessment in the elderly. Therefore, serum albumin and TLC are valuable clinical markers of PEM and the post-operative outcome.
Highlights
The aim of this study was to assess the prevalence of protein energy malnutrition (PEM) and correlation with poor post-operative outcome in the elderly undergoing primary total hip arthroplasty (THA)
An increased risk for six month post-operative morbidity was observed for patients with PEM compared with the non PEM group (HR 6.3, 95% confidence intervals (CI): 1.7–23.1), adjusted for gender, age, type of diagnosis, time to operation, C-reactive protein (CRP), and HB
The aim of this retrospective study was to assess the prevalence of PEM and to investigate whether pre-operative nutritional parameters are associated with poor post-operative outcome in elderly patients undergoing primary total hip arthroplasty
Summary
The aim of this study was to assess the prevalence of protein energy malnutrition (PEM) and correlation with poor post-operative outcome in the elderly undergoing primary total hip arthroplasty (THA). Hypothesis Patients with PEM would have inferior post-operative outcome after THA. Materials and method We retrospectively evaluated the nutritional status of 220 hospitalized patients undergoing THA, 65 years and older. One of the most often affected joints with OA is the hip requiring total hip arthroplasty (THA) in end stage osteoarthritis. Elderly patients show a higher risk for malnutrition. For those affected, this can lead to longer hospital stays with increased morbidity and higher mortality [2, 3]. Poor nutritional status tends to result in impaired wound healing or an increased risk of infections [4]
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