Bohl Daniel D, Shen Mary R, Kayupov Erdan, Della Valle Craig J
Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois.
University of North Carolina School of Medicine, Chapel Hill, North Carolina.
J Arthroplasty. 2016 Jan;31(1):15-21. doi: 10.1016/j.arth.2015.08.028. Epub 2015 Aug 29.
This study investigates the association between preoperative hypoalbuminemia, a marker for malnutrition, and complications during the 30 days after total joint arthroplasty. Patients who underwent elective primary total hip and knee arthroplasty as part of the American College of Surgeons National Surgical Quality Improvement Program were identified. Outcomes were compared between patients with and without hypoalbuminemia (serum albumin concentration <3.5 g/dL) with adjustment for patient and procedural factors. A total of 49603 patients were included. In comparison to patients with normal albumin concentration, patients with hypoalbuminemia had a higher risk for surgical site infection, pneumonia, extended length of stay, and readmission. Future efforts should investigate methods of correcting nutritional deficiencies prior to total joint arthroplasty. If successful, such efforts could lead to improvements in short-term outcomes for patients.
本研究调查了术前低白蛋白血症(一种营养不良标志物)与全关节置换术后30天内并发症之间的关联。作为美国外科医师学会国家外科质量改进计划的一部分,对接受择期初次全髋关节和膝关节置换术的患者进行了识别。对有和没有低白蛋白血症(血清白蛋白浓度<3.5 g/dL)的患者的结局进行了比较,并对患者和手术因素进行了调整。共纳入49603例患者。与白蛋白浓度正常的患者相比,低白蛋白血症患者发生手术部位感染、肺炎、住院时间延长和再入院的风险更高。未来的研究应探讨在全关节置换术前纠正营养缺乏的方法。如果成功,这些努力可能会改善患者的短期结局。