Preoperative malnutrition increases odds of hospital admission and extended length of stay following arthroscopic rotator cuff repair.

BACKGROUND

Rotator cuff repair (RCR) is a common orthopedic procedure frequently performed in the outpatient setting. Malnutrition, as assessed by preoperative serum albumin <3.5 g/dL, has been independently associated with significantly higher risks of multiple adverse outcomes in several orthopedic procedures. The effect of preoperative hypoalbuminemia on short-term outcomes of RCR was previously unknown.

HYPOTHESIS

we hypothesized that preoperative serum albumin <3.5 g/dL would be associated with higher odds of post-operative admission and prolonged length of stay.

METHODS

This study represents a retrospective analysis of the American College of Surgeons National Surgical Quality Improvement Program database (NSQIP) for patients undergoing RCR between 2011 and 2015.

RESULTS

Multivariate regression analysis adjusted for sex, ASA classification, age, BMI, and diabetes status (Table 3) showed preoperative hypoalbuminemia conferred a significantly increased adjusted odds ratio of postoperative admission (adjusted odds ratio 1.711, CI 1.134-2.583, p = 0.011) and extended length of stay (adjusted odds ratio 2.073, CI 1.073-4.003, p = 0.030).

CONCLUSION

Malnutrition as assessed by preoperative serum albumin <3.5 g/dL is significantly associated with increased odds of hospital admission and extended length of stay following arthroscopic RCR. This has clinical implications in surgical patient selection and risk stratification.

LEVEL OF EVIDENCE

III, Retrospective cohort study.