Nutritional index may be valid predictor of complications after TKA
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Onodera’s prognostic nutritional index may be a valid and excellent predictor of complications after total knee arthroplasty, according to results presented at the Musculoskeletal Infection Society Annual Meeting.
Alisina Shahi, MD, and colleagues measured Onodera’s prognostic nutritional index (OPNI) among more than 1,300 patients within 14 days prior to TKA. Researchers collected Charlson and Elixhauser comorbidity indices and assessed complications for up to 12 weeks postoperatively, including periprosthetic joint infection (PJI), wound complications, readmissions and reoperations.
“We used Youden’s test to determine the threshold, multivariate regression model to determine the risk factors and Fisher’s exact test for bivariate analysis,” Shahi said in his presentation here.
OPNI had a calculated threshold of 45.1 and albumin had a calculated threshold of 38.2, according to Shahi. He added 74% of patients had low OPNI and 26% of patients had OPNI levels greater than 45.1.
“Patients with low OPNI had significantly higher rates for PJI, 1.2% compared with 0.2%, and 4.6-times higher readmission rates and 4.2-times higher reoperation rates,” Shahi said.
Unlike OPNI, Shahi noted albumin failed to show a significant association with complications. Shahi said that not all patients with normal albumin levels had normal OPNI levels.
“Of patients with normal albumin, 32% had low OPNI levels, meaning that although the albumin levels were normal, the body was non-nutritionally optimized,” Shahi said.
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Shahi A, et al. Paper 912. Presented at: Musculoskeletal Infection Society Annual Meeting; Aug. 5-6, 2022; Pittsburgh (hybrid meeting).
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