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老年股骨近端骨折手术治疗患者营养状况评估及其与术后并发症的相关性

Evaluation of Nutritional Status and Correlation with Postoperative Complications in Elderly Patients Submitted to Surgical Treatment of Proximal Femoral Fractures.

作者信息

Dias Tiane Raquel da Silva, Batista Bruno Bellaguarda, Chang Rafael Wei Min Leal, Noriega Jorge Enrique Acosta, Figueiredo Giuseppe Lemos Pertoti de

机构信息

Serviço de Ortopedia e Traumatologia, Hospital Universitário Getúlio Vargas (HUGV), Universidade Federal do Amazonas (UFAM), Manaus, AM, Brasil.

出版信息

Rev Bras Ortop (Sao Paulo). 2021 Feb;56(1):104-108. doi: 10.1055/s-0040-1721365. Epub 2021 Feb 19.

Abstract

This study aims to evaluate and correlate the nutritional status with potential complications during the immediate postoperative period of elderly patients surgically treated for proximal femoral fractures.  A prospective, cross-sectional analytical study with a quantitative approach, targeting patients aged 60 years old or more who were admitted to a hospital in Amazonas, Brazil, for surgical treatment of proximal femoral fractures. Surgical complications during the immediate postoperative period and their relationship with the nutritional status of the patient were determined using the mini nutritional assessment (MNA); in addition, the lymphocyte numbers and serum albumin levels were determined and correlated with the length of hospital stay.  The sample consisted of 19 elderly patients, of both genders, with a mean age of 70.8 years. Most of the subjects (68.4%) were female. Malnutrition was diagnosed in 15.8% of the subjects using the body mass index (BMI) as, an anthropometric variable, and the MNA identified 31.6% of the subjects with malnutrition. Regarding total lymphocyte count, 100% of the sample showed a positive association with malnutrition in varying degrees; using serum albumin level as a parameter, malnutrition was identified in 89.4% of the subjects. Malnourished patients had the highest average length of stay. Surgical complications as surgical site infections occurred in 10.5% of the patients at risk of malnutrition.  This study revealed a higher rate of postoperative complications in elderly patients diagnosed with malnutrition.

摘要

本研究旨在评估股骨近端骨折手术治疗的老年患者术后即刻的营养状况,并将其与潜在并发症进行关联分析。 这是一项采用定量方法的前瞻性横断面分析研究,研究对象为年龄60岁及以上、因股骨近端骨折手术治疗而入住巴西亚马孙州一家医院的患者。使用微型营养评定法(MNA)确定术后即刻的手术并发症及其与患者营养状况的关系;此外,测定淋巴细胞数量和血清白蛋白水平,并将其与住院时间进行关联分析。 样本包括19名老年患者,男女皆有,平均年龄为70.8岁。大多数受试者(68.4%)为女性。以体重指数(BMI)作为人体测量变量,15.8%的受试者被诊断为营养不良;MNA法确定31.6%的受试者存在营养不良。就淋巴细胞总数而言,100%的样本显示出与营养不良存在不同程度的正相关;以血清白蛋白水平为参数,89.4%的受试者被确定为营养不良。营养不良患者的平均住院时间最长。有营养不良风险的患者中,10.5%发生了手术部位感染等手术并发症。 本研究显示,诊断为营养不良的老年患者术后并发症发生率更高。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f8ff/7895625/0af6655768c3/10-1055-s-0040-1721365-i1900225en-1.jpg

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