Department of Endocrinology and Nutrition, Centre d'Atenció Integral Dos de Maig, Consorci Sanitari Integral, Barcelona, Spain.
Department of Endocrinology and Nutrition, Centre d'Atenció Integral Dos de Maig, Consorci Sanitari Integral, Barcelona, Spain.
Endocrinol Diabetes Nutr (Engl Ed). 2023 Sep;70 Suppl 3:59-66. doi: 10.1016/j.endien.2023.06.003.
Malnutrition in elderly patients with hip fracture has been described as a factor associated with poor outcomes. This evidence for elderly patients undergoing elective total hip arthroplasty (THA) for osteoarthritis is not well-established.
We retrospectively studied a cohort of patients with an age ≥65 years admitted to the hospital for THA between January 2018 and December 2020. Demographic characteristics were collected. Albumin and total lymphocyte count were included in the pre-operative analysis and 24h postoperatively. Nutritional screening was carried out 24h postoperatively. GLIM criteria were applied for the diagnosis of malnutrition.
25 patients out of the total cohort of 65 (38.4%) were malnourished. Five out of six patients (83.3%) with postoperative complications presented malnutrition compared with 20 of 59 patients (33.8%) without postoperative complications (P=0.028). Mean length of stay (LOS) was 3.49±0.88 days. Five out of six (83.3%) patients with postoperative complications presented LOS >3 days compared with one out of six patients (16.6%) with LOS ≤3 days (P=0.009). 26 patients (40%) were referred to a community health centre, no differences in diagnosis of malnutrition were detected compared with patients who were discharged home. Patients with a diagnosis of malnutrition were significantly older, had a lower body mass index (BMI), a lower preoperative and postoperative albumin and worse anthropometric parameters.
Malnutrition is associated with postoperative complications and longer LOS in elderly patients with elective THA. Risk factors for malnutrition are older age and low BMI.
髋部骨折的老年患者营养不良已被描述为与不良结局相关的因素。对于接受择期全髋关节置换术（THA）治疗骨关节炎的老年患者，这方面的证据尚未得到充分证实。
我们回顾性研究了一组年龄≥65 岁的患者，这些患者在 2018 年 1 月至 2020 年 12 月期间因 THA 住院。收集了人口统计学特征。白蛋白和总淋巴细胞计数包括在术前分析和术后 24 小时。术后 24 小时进行营养筛查。应用 GLIM 标准诊断营养不良。
在总共 65 例患者的队列中，有 25 例（38.4%）存在营养不良。术后并发症的 6 例患者中有 5 例（83.3%）存在营养不良，而无术后并发症的 59 例患者中有 20 例（33.8%）存在营养不良（P=0.028）。平均住院时间（LOS）为 3.49±0.88 天。术后并发症的 6 例患者中有 5 例（83.3%）存在 LOS>3 天，而 LOS≤3 天的 6 例患者中只有 1 例（16.6%）（P=0.009）。26 例（40%）患者被转介到社区卫生中心，与出院回家的患者相比，营养不良的诊断没有差异。诊断为营养不良的患者年龄明显更大，体重指数（BMI）更低，术前和术后白蛋白水平更低，人体测量参数更差。
在接受择期 THA 的老年患者中，营养不良与术后并发症和 LOS 延长相关。营养不良的危险因素是年龄较大和 BMI 较低。
