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Revision Total Hip Arthroplasty: Evaluating the Utility of the Geriatric Nutritional Risk Index as a Risk Stratification Tool.
Lung, Brandon E; Liu, Steven H; Burgan, Jane; Loyst, Rachel A; Tedesco, Amanda; Nicholson, James J; McMaster, William C; Yang, Steven; Stitzlein, Russell.
Afiliación
  • Lung BE; Department of Orthopaedic Surgery, University of California Irvine, Orange, CA, USA.
  • Liu SH; Renaissance School of Medicine, Stony Brook University, Stony Brook, NY, USA.
  • Burgan J; Renaissance School of Medicine, Stony Brook University, Stony Brook, NY, USA.
  • Loyst RA; Renaissance School of Medicine, Stony Brook University, Stony Brook, NY, USA.
  • Tedesco A; School of Medicine, University of California Irvine, Irvine, CA, USA.
  • Nicholson JJ; Department of Orthopaedic Surgery, Stony Brook University, Stony Brook, NY, USA.
  • McMaster WC; Department of Orthopaedic Surgery, University of California Irvine, Orange, CA, USA.
  • Yang S; Department of Orthopaedic Surgery, University of California Irvine, Orange, CA, USA.
  • Stitzlein R; Department of Orthopaedic Surgery, University of California Irvine, Orange, CA, USA.
Arthroplast Today ; 28: 101430, 2024 Aug.
Article en En | MEDLINE | ID: mdl-38983939
ABSTRACT

Background:

This study investigates the association between the Geriatric Nutritional Risk Index (GNRI), a measure of malnutrition risk, and 30-day postoperative complications following revision total hip arthroplasty (rTHA).

Methods:

The American College of Surgeons National Surgical Quality Improvement Program database was queried for all patients ≥65 who underwent aseptic rTHA between 2015 and 2021. The final study population (n = 7119) was divided into 3 groups based on preoperative GNRI normal/reference (GNRI >98) (n = 4342), moderate malnutrition (92 ≤ GNRI ≤98) (n = 1367), and severe malnutrition (GNRI <92) (n = 1410). Multivariate logistic regression analysis was conducted to investigate the association between preoperative GNRI and 30-day postoperative complications.

Results:

After controlling for significant covariates, the risk of experiencing any postoperative complications was significantly higher with both moderate (odds ratio [OR] 2.08, P < .001) and severe malnutrition (OR 8.79, P < .001). Specifically, moderate malnutrition was independently and significantly associated with deep vein thrombosis (OR 1.01, P = .044), blood transfusions (OR 1.78, P < .001), nonhome discharge (OR 1.83, P < .001), readmission (OR 1.27, P = .035), length of stay >2 days (OR 1.98, P < .001), and periprosthetic fracture (OR 1.54, P = .020). Severe malnutrition was independently and significantly associated with sepsis (OR 3.67, P < .001), septic shock (OR 3.75, P = .002), pneumonia (OR 2.73, P < .001), urinary tract infection (OR 2.04, P = .002), deep vein thrombosis (OR 1.01, P = .001), pulmonary embolism (OR 2.47, P = .019), acute renal failure (OR 8.44, P = .011), blood transfusions (OR 2.78, P < .001), surgical site infection (OR 2.59, P < .001), nonhome discharge (OR 3.36, P < .001), readmission (OR 1.69, P < .001), unplanned reoperation (OR 1.97, P < .001), length of stay >2 days (OR 5.41, P < .001), periprosthetic fractures (OR 1.61, P = .015), and mortality (OR 2.63, P < .001).

Conclusions:

Malnutrition has strong predictive value for short-term postoperative complications and has potential as an adjunctive risk stratification tool for geriatric patients undergoing rTHA.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Arthroplast Today Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Arthroplast Today Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos