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Severe malnutrition associated with poor outcomes after hip fracture surgery
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Results published in the Journal of Orthopaedic Trauma showed an independent association between increasing severity of hypoalbuminemia and poorer 30-day outcomes after hip fracture surgery.
“In our study, we found that increasing severity of malnutrition was associated with progressively poorer 30-day outcomes following hip fracture surgery,” Andrew S. Chung, DO, co-author of the study, told Healio.com/Orthopedics. “Translated clinically, this represents a useful measure by which to identify patients who may require closer multi-disciplinary monitoring and more aggressive perioperative nutritional optimization.”
Chung and colleagues collected patient demographic, comorbidity and preoperative laboratory data and complication, reoperation and readmission data on 12,373 patients who underwent hip fracture surgery between 2006 and 2013. Researchers determined the effect of increasing severity of malnutrition on rates of 30-day postoperative complications, readmissions and reoperations using multivariate logistic regression.
Results showed 52.6% of patients had normal albumin levels, 25.9% were mildly malnourished, 18.3% were moderately malnourished and 3.2% were severely malnourished. Researchers found a two-fold increase in the odds for postoperative complications and mortality among patients with severe malnutrition when compared with patients with mild malnutrition. Patients with a higher severity of malnutrition had significantly longer lengths of stay and higher odds of experiencing a related readmission.
“The ramifications of this study likely extend outside the realm of hip fracture surgery to other orthopedic surgical settings as well,” Chung said. “Ultimately, the information presented here serves as yet another risk-assessment tool that should be utilized in both the surgical decision-making process and during the preoperative discussion.” – by Casey Tingle
Disclosures: The authors report no relevant financial disclosures.
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