Poor Nutritional Status Research Articles

Prognostic Nutritional Index as a Novel Predictor of In-Stent Restenosis: A Retrospective Study.

Background and Objectives: In-stent restenosis (ISR) is a major problem in patients undergoing percutaneous coronary intervention. The prognostic nutritional index (PNI) is a nutritional status score used in the literature to determine the prognosis of coronary artery disease. In this study, we aimed to investigate the effect of preprocedural PNI values on the risk of ISR in patients with stable coronary artery disease who underwent successful percutaneous coronary intervention. Materials and Methods: This retrospective study included 809 patients. Stent restenosis was evaluated in the follow-up coronary angiography of the patients due to stable angina pectoris or acute coronary syndrome. The patients were divided into two groups based on those with (n = 236) and without (n = 573) in-stent restenosis, and their nutritional status was compared with PNI. The PNI values before the first angiography of the patients were calculated. Results: The mean PNI score was significantly lower in patients with ISR than in those without ISR (49.5 vs. 52.3, p < 0.001). Concerning the results of the Cox regression hazard model for predictors of ISR, PNI was significantly associated with the development of ISR (HR = 0.932, 95% CI: 0.909-0.956, p < 0.001). In addition, stent type, stent length, and diabetes mellitus were associated with the development of ISR. Conclusions: A low PNI value indicates poor nutritional status, which is thought to accelerate inflammation processes and cause atherosclerosis and ISR.

A hospital-based cross-sectional study on health problems and the factors affecting the health of adolescent girls in rural population

Background: Many adolescent girls die prematurely due to various preventable or treatable reasons, and many more suffer from chronic ill-health and disability. The objective of this study was to assess the nutritional status, gynaecological problems, and psychological problems of adolescent girls attending the Paediatric OPD and ward. The aim was to study the prevalence of malnutrition in adolescent girls attending paediatric OPD and ward. Methods: A cross-sectional hospital-based study was conducted on adolescent girls attending Paediatric OPD and ward of Adichunchanagiri institute of medical sciences and research centre, B. G. Nagara from November 2019 to November 2020. A total of 374 adolescent girls (10-17 years) were enrolled. Clinical examination was done after recording their weight and height. Body Mass Index was computed. Results: Mean age of the study participants was 13.05 years, and majority of them were from low socioeconomic status. Around 41.2% of the fathers had semi-skilled jobs, and 19.3% of the mothers had clerical jobs, shop owners, or farmers. About 71.1% of the adolescents attained menarche with a mean age of 13.2 ± 0.11 years. 62% had normal BMI, followed by 25.1% with underweight, overweight in 9.4%, and obese in 3.5% of the adolescents. Around 62% of the adolescents were normally nourished, and 38% were malnourished. Conclusions: Socioeconomic status, occupation of mothers, family types and diet of the adolescents had a significant association with poor nutritional status. It is important to understand the need for evaluation of malnourished adolescent females and their causes to prevent chronic illness and death among them.

The Impact of Transjugular Intrahepatic Portosystemic Shunt on Nutrition in Liver Cirrhosis Patients: A Systematic Review.

Liver cirrhosis leads to clinically significant portal hypertension. Transjugular intrahepatic portosystemic shunt (TIPS) has been shown to effectively reduce the degree of portal hypertension and treat its complications. However, poor nutritional status has been shown to be associated with hepatic encephalopathy, acute on chronic liver failure, and mortality following TIPS placement. The purpose of this systematic review is to create another perspective and evaluate the effect of TIPS placement on the nutritional status of patients with liver cirrhosis. A comprehensive search of four major electronic databases was conducted to identify studies that assessed the nutritional status of cirrhotic patients before and after TIPS placement. The risk of bias was evaluated using ROBINS-I guidelines. Fifteen studies were analyzed in this review. The results indicate that among the 11 studies that evaluated changes in ascites-free weight and body mass index or body cell mass, 10 reported an improvement in one or more measures. Furthermore, all seven studies that evaluated changes in muscle mass demonstrated an increase in muscle mass. Among the four studies that evaluated subcutaneous fat tissue, three showed a significant expansion, while two out of three studies evaluating visceral fat tissue reported a significant reduction. The results of this systematic review suggest that TIPS placement is associated with improvement in the nutritional status of cirrhotic patients, indicated by an increase in ascites-free weight, body mass index, and muscle mass. Additionally, TIPS placement leads to a shift in the distribution of fat mass, with a preference for subcutaneous over visceral adipose tissue. Notably, sarcopenic patients seem to benefit the most from TIPS placement in terms of nutritional status.

Controlling Nutritional Status (CONUT) Score as a Potential Prognostic Indicator of In-Hospital Mortality, Sepsis and Length of Stay in an Internal Medicine Department.

The controlling nutritional status (CONUT) score represents poor nutritional status and has been identified as an indicator of adverse outcomes. Our aim was to evaluate the prognostic role of the CONUT score on in-hospital outcomes in an Internal Medicine Department. This is a retrospective study analyzing data from 369 patients, divided into four groups based on the CONUT score: normal (0-1), mild-high (2-4), moderate-high (5-8), and marked high (9-12). In-hospital all-cause mortality increased from normal to marked high CONUT score group (2.2% vs. 3.6% vs. 13.4% vs. 15.3%, p < 0.009). Furthermore, a higher CONUT score was linked to a longer length of hospital stay (LOS) (9.48 ± 6.22 vs. 11.09 ± 7.11 vs. 12.45 ± 7.88 vs. 13.10 ± 8.12, p < 0.013) and an increased prevalence of sepsis. The excess risk of a high CONUT score relative to a low CONUT score remained significant after adjusting for confounders (all-cause mortality: OR: 3.3, 95% CI: 1.1-9.7, p < 0.02; sepsis: OR: 2.7, 95% CI: 1.5-4.9, p < 0.01; LOS: OR: 2.1, 95% CI: 1.2-3.9, p < 0.007). The present study demonstrated that an increased CONUT score is related to a higher risk of short-term in-hospital death and complications.

Assessment of nutritional status using objective and subjective methods in Greek patients with cancer

Summary Purpose Malnutrition constitutes an important complication of cancer. Nutritional status is associated with the progression of malignant neoplasms. This study aimed to assess the nutritional status of patients with cancer using objective and subjective assessment methods. Materials and methods The following validated questionnaires were used to assess the nutritional status of 152 patients with cancer recruited in Attica, Greece: Patient-Generated Subjective Global Assessment (PG-SGA), Nutritional Risk Screening-2002 (NRS-2002), Simplified Nutritional Appetite Questionnaire (SNAQ). Geriatric nutritional risk index (GNRI) was calculated, handgrip strength (HGS) test was carried out, and the arm circumference (MUAC) and triceps skinfold thickness (TSF) were measured. Results Based on the PG-SGA assessment, 54.9% of the individuals were severely malnourished. Imminent risk was observed in 83.6% (NRS-2002) and 48.7% of participants were at increased risk of a 5% reduction in body weight within the next 6‑months (SNAQ). Severely malnourished patients experienced significant weight reduction in the 6 months prior to recruitment and had lower HGS and TSF. MUAC was similar within the PG-SGA categories. High risk for malnutrition was estimated for geriatric patients (GNRI: 46.45 [IQR: 5.17]). Malnourishment, based on PG-SGA, was positively associated with percent weight loss within the past 6 months and negatively associated with body mass index (BMI), hemoglobin (Hgb), HGS, and MUAC (all p ≤ 0.05). Conclusion The present study highlighted a high risk of malnutrition in patients with cancer. Poor nutritional status was positively associated with weight loss, Hgb, and MUAC and negatively associated with BMI, HGS, and TSF.

Poor Preprocedural Nutritional Status Is Associated With Lower Physical Performance And More Decline In Muscle Mass After Transcatheter Aortic Valve Implantation

Poor Preprocedural Nutritional Status Is Associated With Lower Physical Performance And More Decline In Muscle Mass After Transcatheter Aortic Valve Implantation

Prognostic Value of Skeletal Muscle Loss in Patients with Hepatocellular Carcinoma Treated with Hepatic Arterial Infusion Chemotherapy

Sarcopenia-related factors, including the skeletal muscle index (SMI), are reportedly associated with prognosis in patients with hepatocellular carcinoma (HCC) receiving various treatments. However, there is no evidence relating to hepatic arterial infusion chemotherapy (HAIC). In this study, we investigated whether a low SMI was associated with worse clinical outcomes of HAIC. Seventy patients with advanced HCC were included. Clinical outcomes were compared between the decreased SMI (n = 27) and non-decreased SMI (n = 43) groups, which were classified according to changes in the SMI after 3 weeks of treatment. In the prognostic analysis, patients in the decreased SMI group had significantly shorter progression-free and overall survival (OS) than those in the non-decreased SMI group. In addition, poor nutritional status and liver function were associated with an immediate decrease in the SMI after HAIC. The therapeutic effect was worse in the decreased SMI group than in the non-decreased SMI group, although the incidence of adverse events did not significantly differ. In multivariate analysis, a decreased SMI at 3 weeks after HAIC was identified as a significant independent factor associated with OS. A decreased SMI in patients with advanced HCC undergoing HAIC was associated with poor prognosis. It is effective to monitor the SMI to evaluate general conditions and predict clinical outcomes.

Lipocalin-2 and neutrophil activation in pancreatic cancer cachexia.

Cancer cachexia is a multifactorial syndrome characterized by body weight loss and systemic inflammation. The characterization of the inflammatory response in patients with cachexia is still limited. Lipocalin-2, a protein abundant in neutrophils, has recently been implicated in appetite suppression in preclinical models of pancreatic cancer cachexia. We hypothesized that lipocalin-2 levels could be associated with neutrophil activation and nutritional status of pancreatic ductal adenocarcinoma (PDAC) patients. Plasma levels of neutrophil activation markers calprotectin, myeloperoxidase, elastase, and bactericidal/permeability-increasing protein (BPI) were compared between non-cachectic PDAC patients (n=13) and cachectic PDAC patients with high (≥26.9 ng/mL, n=34) or low (<26.9 ng/mL, n=34) circulating lipocalin-2 levels. Patients' nutritional status was assessed by the patient-generated subjective global assessment (PG-SGA) and through body composition analysis using CT-scan slices at the L3 level. Circulating lipocalin-2 levels did not differ between cachectic and non-cachectic PDAC patients (median 26.7 (IQR 19.7-34.8) vs. 24.8 (16.6-29.4) ng/mL, p=0.141). Cachectic patients with high systemic lipocalin-2 levels had higher concentrations of calprotectin, myeloperoxidase, and elastase than non-cachectic patients or cachectic patients with low lipocalin-2 levels (calprotectin: 542.3 (355.8-724.9) vs. 457.5 (213.3-606.9), p=0.448 vs. 366.5 (294.5-478.5) ng/mL, p=0.009; myeloperoxidase: 30.3 (22.1-37.9) vs. 16.3 (12.0-27.5), p=0.021 vs. 20.2 (15.0-29.2) ng/mL, p=0.011; elastase: 137.1 (90.8-253.2) vs. 97.2 (28.8-215.7), p=0.410 vs. 95.0 (72.2-113.6) ng/mL, p=0.006; respectively). The CRP/albumin ratio was also higher in cachectic patients with high lipocalin-2 levels (2.3 (1.3-6.0) as compared to non-cachectic patients (1.0 (0.7-4.2), p=0.041). Lipocalin-2 concentrations correlated with those of calprotectin (rs =0.36, p<0.001), myeloperoxidase (rs =0.48, p<0.001), elastase (rs =0.50, p<0.001), and BPI (rs =0.22, p=0.048). Whereas no significant correlations with weight loss, BMI, or L3 skeletal muscle index were observed, lipocalin-2 concentrations were associated with subcutaneous adipose tissue index (rs =-0.25, p=0.034). Moreover, lipocalin-2 tended to be elevated in severely malnourished patients compared with well-nourished patients (27.2 (20.3-37.2) vs. 19.9 (13.4-26.4) ng/mL, p=0.058). These data suggest that lipocalin-2 levels are associated with neutrophil activation in patients with pancreatic cancer cachexia and that it may contribute to their poor nutritional status.

The relationship between tooth loss and pre-elderly nutritional status and quality of life

Background: Tooth loss leads to decreased masticatory function, which affects nutritional intake. Tooth loss accompanied by poor nutritional status affects quality of life both physically and psychosocially. Purpose: This study was conducted to identify the relationship between number of teeth lost due to nutritional status and quality of life. Methods: A study conducted at Gulai Bancah Primary Health Care in Bukittinggi. Participants were recruited using a non-probability purposive sampling technique. 178 pre-elderlies aged between 45 and 59 years took part in this study. Tooth loss was reported in the dental examination format while nutritional status and quality of life pertaining to dental and oral health were determined using the Mini Nutritional Assessment (MNA) and the Geriatric Oral Health Assessment Index (GOHAI). Pearson correlation and path analysis were utilized to analyze the data. Results: The Pearson correlation test indicated a moderate correlation between tooth loss and nutritional status (r = -0.549) and a strong correlation between the number tooth lost and quality of life (r = -0.742). Pathway analysis confirmed that the direct effect value (beta coefficient = 0.552) was greater than the indirect effect value (beta coefficient = 0.189). The findings indicated that, indirectly, the amount of tooth loss mediated with nutritional status had no significant relationship to quality of life. Conclusion: An increase in tooth loss leads to pre-elderly poor nutritional status and quality of life. However, nutritional status is not an intermediate factor between the number of teeth lost and pre-elderly quality of life.

Association of prepregnancy body mass index and gestational weight gain on severity of optic nerve hypoplasia.

Optic nerve hypoplasia (ONH) is a birth defect of unknown etiology and a leading cause of visual impairment in developed countries. Recent studies suggest that factors of deprivation and exposures of poor nutritional status, such as lower gestational weight gain (GWG), may be associated with increased risk of ONH. The present study describes the prenatal features of mothers of ONH cases, including prepregnancy BMI and GWG, and the associations with clinical features of disease severity. Retrospective study of prenatal records for cases of ONH enrolled in a research registry. Prepregnancy BMI and GWG were compared to maternal characteristics and clinical findings of ONH severity including bilaterality, hypopituitarism, and neuroradiographic abnormalities. Compared to population-based normative data of births in the United States, mothers of ONH cases (n=55) were younger (23.3 vs. 25.8 years; p=0.03), with higher incidence of inadequate GWG (34.0% vs. 20.4%; p=0.03) predominantly in the first and second trimesters. The presence of major brain malformations was associated with younger maternal age (21.6 [IQR 19.4, 24.7] vs. 24.9 years [IQR 22.1, 28.5] [p=0.02]), primiparity (44.1% vs. 13.3%; p=0.05) and decreased prepregnancy BMI (20.9kg/m2 [19, 22.5] vs. 25.5kg/m2 [21.3, 28.2]; p < 0.01). Decreased prepregnancy BMI and inadequate GWG correlated with clinical features of ONH severity, specifically bilateral disease and presence of major brain malformations.

The Effect of Supplementary Food in the Form of Moringa Leaf Dry Brownies on the Increasing Weight of Under-Fives with Underweight Status in Wonokerto Village Turi Sleman

In 2020, the percentage of underweight children under-five in Indonesia is high, which is 6.7% or a total of 779,139 children under-five. This shows that the problem of under-five malnutrition is still high both in Indonesia and the regions. This study aims to determine the effect of providing additional food in the form of dry brownies of moringa leaves on the increase in body weight of toddlers with poor nutritional status. This study used Pre-Experimental designs, One Group Pretest and Posttest with a sample of 34 underweight toddlers were intervened for 21 days. The results showed that there was an increase under-five weight between before and after being given moringa leaf brownies with a p value of 0.000 &lt; 0.05. The conclusion is there is an effect of providing additional food in the form of dry brownies of Moringa leaves on increasing body weight in under-fives with underweight status.

WEO Newsletter.

WEO Newsletter.

The relationship between nutritional status before chemotherapy with nutritional status after chemotherapy in locoregionally advanced nasopharyngeal carcinoma patients

Background: Malnutrition in nasopharyngeal carcinoma (NPC) patients is caused by various factors such as tumor localization, metabolic derangement, and side effects of therapy. Poor nutritional status in cancer patients is associated with serious clinical consequences such as poor quality of life, higher treatment toxicity, and poor prognosis. The purpose of this study was to determine the effect of nutritional status before chemotherapy on the nutritional status after chemotherapy in non-metastatic advance-stage NPC patients. Methods: This study was an observational study with a cross sectional design using secondary data involving non-metastatic advanced-stage NPC patients undergoing chemotherapy at dr. Kariadi Hospital Semarang in January 2020 – June 2022. The sampling technique used was consecutive sampling. Nutritional status was measured by malnutrition criteria according to the American Society for Parenteral and Enteral Nutrition (ASPEN). Statistical analysis was performed with Chi-Square and McNemar analysis test. Results: Total sample of this study was 55 subjects. The results of this study were there was a relationship between nutritional status before chemotherapy and nutritional status after chemotherapy in non-metastatic advanced-stage NPC patients (P&lt;0.05). All subjects were malnourished before chemotherapy, with 12.7% moderately malnourished and 87.3% severely malnourished. All subjects were malnourished after chemotherapy, with 41.8% moderately malnourished and 58.2% severely malnourished, decreased nutritional status of post-chemotherapy non-metastatic advanced NPC patients was related to the length of chemotherapy (p&lt;0.05), but not related to comorbidities, age, and stage of chemotherapy (p&gt;0.05). Conclusion: There is a relationship between nutritional status before chemotherapy and nutritional status after chemotherapy in non-metastatic advanced-stage NPC patients.

The Relationship Between Utilization of Health Service Center (Posyandu) and the Nutritional Status of Infants during the Pandemic

The aim of this research is to investigate the relationship between the utilization of posyandu and the nutritional status of toddlers during the pandemic in Muneng Village, Candiroto Sub-district, Temanggung Regency, Central Java. The design of this research is cross-sectional. The sample taken is 59 toddlers using total sampling technique. The data were analyzed with a Chi Square test at 95% significance level . The results showed that 56 respondents (95%) utilized posyandu more than 3 times, and there were 3 respondents (27.8%) who utilized it less than 3 times. The nutritional status of the toddlers showed that most of the respondents had a good nutritional status, with 53 respondents (89.8%), while 6 respondents (10.2%) had a poor nutritional status. There was a relationship between the utilization of posyandu and the nutritional status of toddlers during the pandemic. The conclusion of this research is that posyandu activities are crucial in controlling the development of toddlers, especially in terms of their nutritional status. The recommendation is for mothers to be more active in utilizing posyandu activities.

Malnutrition associated with readmission in elderly patients with chronic obstructive pulmonary disease.

Malnutrition associated with readmission in elderly patients with chronic obstructive pulmonary disease.

Undernutrition Scored Using the CONUT Score with Hypoglycemic Status in ICU-Admitted Elderly Patients with Sepsis Shows Increased ICU Mortality

This study aimed to clarify whether the influence of undernutrition status and the degree of glycemic disorders affected the prognosis of patients with sepsis. A total of 307 adult patients with sepsis were retrospectively enrolled and analyzed. Characteristics, including nutrition status, calculated according to the Controlling Nutritional Status (CONUT) score of survivors and non-survivors, were examined. The independent prognostic factors of these patients with sepsis were extracted using multivariable logistic regression analysis. The CONUT scores in three glycemic categories were compared. Most patients with sepsis (94.8%) in the study had an undernutrition status according to their CONUT scores. High CONUT scores (odds ratio, 1.214; p = 0.002), indicating a poor nutritional status, were associated with high mortality. The CONUT scores in the hypoglycemic group were significantly higher than those in other groups with an undernutrition status (vs. hyperglycemic, p < 0.001; vs. intermediate glycemic, p = 0.006). The undernutrition statuses of patients with sepsis in the study scored using the CONUT were independent predictors of prognostic factors.

Nutritional status and effect of highly active anti-retroviral therapy (HAART) on selected trace elements in people living with HIV in Ghana

Background and objectivesEssential trace elements obtained from our diet are crucial for the initiation and development of host defence by the immune system. Trace elements such as selenium (Se), zinc (Zn) and copper (Cu) are important for immune competence, particularly in vulnerable population. Poor nutrition status including deficiencies of these vital elements is associated with immune abnormalities and increased susceptibility to infectious diseases. MethodsA comparative study involving a cohort of three hundred and twenty-five (325) participants comprising: 166 persons living with HIV (PLWH) (consisting of 100 on HAART and 66 HAART-treatment naive) and one hundred and fifty-nine (159) non-HIV controls were recruited. Waist to hip ratio and dietary habits were assessed to determine respondents’ nutritional status. Serum Zn, Se and Cu concentrations were estimated by neutron activation method. ResultsMean body mass index (BMI) of respondents was 24.7±4.8 kg/m2. Dietary recommended intakes (DRIs) of macronutrient [energy (69%), carbohydrates (86%) and fats (76%)] and micronutrient [(vitamin B2 (63%), vitamin D (15%), folate (47%) and calcium (63%)] were not adequately met by all groups. PLWH on HAART had a significantly higher total body fat (p=0.004) and visceral fat (p<0.001). Dietary intake of Se, Zn and Cu were highest among the controls (47.0±5.4 µg, 12.4±2.9 mg and 843±15.2 mg respectively) and least, among the HAART treatment naïve group (10.1±5.6 µg, 2.1±0.9mg and 438±16.3 mg respectively), although serum concentrations were significantly lower (0.63±0.21 µmol/L, 1.33±0.92 µmol/L and 1.12±0.14 µmol/L; p<0.001, respectively). Dietary intake of Se and Cu were not associated with their serum concentrations, but treatment status was significantly associated with their serum concentrations (p-value<0.001). Respondents on Zidovudine (AZT) + Lamivudine (3TC) + Nevirapine (NVP) had higher serum Se and Cu concentrations but lower Zn concentrations compared to those on other medications. ConclusionMultiple nutrient intakes among PLWH were not adequate; thus, dietary counseling and micronutrient supplementation are strongly recommended, as food security strategies by stakeholders involved in the nutrition management of PLWH in Ghana are also needed. Intake of AZT + 3TC + NVP may improve serum concentrations of Se, and Cu, but could negatively affect serum Zn concentration.

‘What We Are and Have - To Behave’: Behavioural Problems and Nutritional Status of Children from an Urban Slum in Pune

Slums are high-risk environments for children, which increase the likelihood of development of behavioral problems and poor nutritional status. A definite relationship between behavior and nutrition has been defined in children living in other settings, but evidence from slums is lacking. Thus, the purpose of this study was to understand the nature of the association between behavior and nutrition in children from an urban slum. This study included children of age 6-12 years (n=70). Convenience sampling was used to recruit participants. The parents of the children were interviewed, and details on socio-demography, socioeconomic status (SES), behavior (by Strengths and Difficulties Questionnaire), and diet of the child were recorded. Anthropometrics of the children were measured using standard procedures, which were used to categorize them by body mass index (BMI) and mid-upper arm circumference (MUAC). Data were analyzed using descriptive statistics and analytical tests. It was observed that children who were underweight or with an undernourished MUAC were less likely to display conduct problems and low prosocial behavior than children of normal weight. Children with an over nourished MUAC were more likely to be hyperactive. Decreased intake of protein and micronutrients corresponded to a lower prosocial behavior score. Intake of potassium was less among children who were hyperactive, while intake of sodium from food was more among children with a raised total difficulties score. All these associations continued to be significant even after controlling for demographic variables. The findings of this study reiterate the need to include nutrition as an important component of studies and interventions targeting the mental health and behavior of vulnerable children in slums.

The effects of hypoalbuminemia in obese patients undergoing total joint arthroplasty.

Total joint arthroplasty (TJA) is a highly effective surgery. However, poor nutritional status has been associated with worse outcomes. In orthopedics, nutrition status is commonly evaluated using serum albumin. When albumin levels fall below 3.0g/dL, wound healing ability becomes impaired. Typically, malnutrition is associated with low BMI, but malnourished patients can also be obese. The goals of this study were to investigate the relationship between malnourishment represented through albumin levels of obese patients and likelihood of postoperative complications. A retrospective review of patients undergoing primary TJA from 2016 to 2020 in the American College of Surgeons National Surgical Quality Improvement Program national database was performed. Patients with an albumin of < 3.5g/dL were considered to have hypoalbuminemia and those with ≥ 3.5g/dL were considered normal albumin. Univariate analysis was used to determine demographic and comorbidity differences between those with and without hypoalbuminemia. Outcomes of interest included length of stay, resource utilization, discharge disposition, and unplanned readmissions. Multivariate logistic regression examined albumin as a predictor of increased resource utilization and complications after controlling for possible confounding variables. Of the 79,784 patients, 4.96% of patients had low albumin. Those with hypoalbuminemia were nearly 1.5years older than those with normal albumin, were more likely to be black, female, and had an overall increased comorbidity burden as shown by percent of patients with ASA > 3 (all p < 0.001). After risk adjustment, those with hypoalbuminemia and a BMI of 35 + had greater risk of complications and increased resource utilization. Our results demonstrated the prevalence of malnutrition increases as a patient's BMI increases. Further, hypoalbuminemia was associated with increased resource utilization and increased complication rates in all obese patients. We suggest screening albumin levels in obese patients preoperatively to give surgeons the best opportunity to optimize patient nutrition before undergoing surgery.

Osteoarticular tuberculosis cases in the southwest of China: A 9-year retrospective study.

Osteoarticular tuberculosis (TB) is an uncommon form of extrapulmonary TB. In this study, we analyzed the epidemiological characteristics, common sites, and drug resistance profiles of osteoarticular TB infections occurring in southwest China. A total of 3,254 cases of patients clinically diagnosed with osteoarticular TB infections between 2013 and 2021 were retrospectively analyzed. Patients' demographic and clinical characteristics were collected. Drug sensitivity testing was performed using the microporous plate ratio method. Chi-squared analysis was used to analyze the rates of and trends in mycobacterial isolates. Of the 3,254 patients, 1,968 (60.5%) were men and boys, and 1,286 (39.5%) were women and girls; patients' ages ranged from 1 to 91 years, with an average of 42 ± 19.3 years. In terms of disease, 2,261 (69.5%) had spinal TB, mainly thoracic (815, 36%) or lumbar (1,080, 48%); joint TB was found in 874 cases (26.9%), mainly occurring in the knee (263, 30%) or hip (227, 26%); and both spinal and joint TB were observed in 119 cases (3.7%). Drug susceptibility tests were performed on 241 isolated strains of MTB; 70 strains (29.0%) were resistant to at least one drug, and MDR-TB and XDR-TB were observed in 7.1 and 1.2% of strains, respectively. In southwest China over this period, osteoarticular TB mainly affected middle-aged and young men with poor nutritional status. Patients from ethnic minority areas also accounted for a large proportion of cases. Spinal TB is prone to occur in the lumbar and thoracic vertebrae, and joint TB is prone to occur in the lower limb joints. Additionally, there has been an increasing trend in the number of TB cases over the past 9 years, and drug resistance has also increased.