Malnutrition in Joint Arthroplasty: Prospective Study Indicates Risk of Unplanned ICU Admission
Atul F. Kamath, MD, Caitlin L. McAuliffe, BS, Laura M. Kosseim, MD, Finnah Pio, MD, and Eric Hume, MDHip
Background:
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.
Methods:
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.
Results:
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.
Conclusion:
Patients with poor nutritional status must be counseled on the risks of adverse medical complications.
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