Malnutrition in Joint Arthroplasty: Prospective Study Indicates Risk of Unplanned ICU Admission.

Kamath, Atul F; McAuliffe, Caitlin L; Kosseim, Laura M; Pio, Finnah; Hume, Eric · Arch Bone Jt Surg · 2016

prospective_cohort · Level II

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Abstract

Malnutrition has been linked to poor outcomes after elective joint arthroplasty, but the risk of unplanned postoperative intensive care unit (ICU) admission in malnourished arthroplasty patients is unknown. 1098 patients were followed as part of a prospective risk stratification program at a tertiary, high-volume arthroplasty center. Chronic malnutrition was defined as preoperative albumin <3.5 g/dL. The overall incidence of malnutrition was 16.9% (primary and revision arthroplasty patients). Average BMI was highest for patients in albumin category 3.0-3.5 (BMI 35.7). Preoperative albumin <3.0 and <3.5 g/dL translated to 15.4% and 3.8% rates of unplanned ICU admission, respectively, indicating nutritional status to be a factor in postoperative ICU admission. Patients with poor nutritional status must be counseled on the risks of adverse medical complications.