Maheshwari Vikas, Choudhury Arghya Kundu, Yadav Robin, Dhingra Mohit, Kant Ravi, Kalia Roop Bhushan
Department of Orthopeaedics, All India Institute of Medical Sciences, Rishikesh, India.
Indian J Orthop. 2024 Feb 4;58(3):298-307. doi: 10.1007/s43465-023-01090-3. eCollection 2024 Mar.
Malnourished adults with knee osteoarthritis (OA) have a lower propensity for physical activities, leading to post-surgical stress and poorer clinic-functional outcomes. The study is aimed to propose an integrative screening procedure for patients and to identify a subset of patients who are undernourished or at risk of undernutrition in the Indian population.
A hospital-based cross-sectional study was conducted at a tertiary care, a university-level teaching hospital for seven months, which included knee OA patients above the age of 45 years, and the following criteria were evaluated anthropometric measurement and blood biochemical parameters and nutritional scoring system.
The current study reports a high prevalence of malnutrition (69.5%) in patients with knee OA in the Indian population based on blood biochemical levels, and late presenters are associated with poor nutritional status of an individual. A single gold standard blood biochemical test, serum albumin alone, reports many malnourished individuals in the population, and the remaining blood biochemical parameters may not yield any additional information. Mini nutritional assessment, mid-arm circumference, and mid-calf circumference are poor predictors of malnutrition, and we need a revised cut-off for our group of patients.
In the cohort of OA Knee, the prevalence of malnutrition is high (69.5%) in the Indian population. Serum Albumin is the best parameter to detect the presence of malnutrition preoperatively, and MNS is not applicable to detect malnutrition in our subset of patients. The study recommends routinely measuring serum albumin levels in all patients to correct the nutritional abnormality preoperatively, resulting in better surgical outcomes and reduced post-operatively complications.
IV.
患有膝骨关节炎(OA)的营养不良成年人进行体育活动的倾向较低,这会导致术后应激反应,并使临床功能结局更差。本研究旨在为患者提出一种综合筛查程序,并在印度人群中识别出营养不良或有营养不良风险的患者亚组。
在一家大学级别的三级护理教学医院进行了为期七个月的基于医院的横断面研究,研究对象包括45岁以上的膝骨关节炎患者,并对以下标准进行了评估:人体测量、血液生化参数和营养评分系统。
根据血液生化水平,本研究报告印度人群中膝骨关节炎患者的营养不良患病率很高(69.5%),且就诊较晚的患者个体营养状况较差。单一的金标准血液生化检测,即仅检测血清白蛋白,会报告出人群中有许多营养不良个体,而其余血液生化参数可能无法提供任何额外信息。简易营养评估、上臂围和小腿围对营养不良的预测能力较差,我们需要为我们的患者群体修订临界值。
在膝骨关节炎队列中,印度人群的营养不良患病率很高(69.5%)。血清白蛋白是术前检测营养不良的最佳参数,而简易营养评估不适用于检测我们患者亚组中的营养不良情况。该研究建议对所有患者常规测量血清白蛋白水平,以在术前纠正营养异常,从而获得更好的手术效果并减少术后并发症。
四级