Jacques Anna, Niedzielak Timothy, Eaddy Samuel G, Santos Radleigh, Tannenbaum Stacey L, Rush Joel, Keener Emily, Neway William, Roth Bradley, Perez Edward, Cross Brian J
Department of Orthopedic Surgery, Broward Health Medical Center, Fort Lauderdale, FL.
Mercyhealth Javon Bea Hospital, Rockford, IL.
OTA Int. 2025 May 22;8(2):e402. doi: 10.1097/OI9.0000000000000402. eCollection 2025 Jun.
To evaluate prealbumin (PAB) as a prognostic indicator for early detection of malnutrition risk upon admission and its correlation with in-hospital complications and length of stay (LOS) in patients with orthopedic trauma.
Retrospective cohort.
Urban academic Level 1 trauma center.
PATIENTS/PARTICIPANTS: One hundred fifty-eight patients aged 18 years or older with acute traumatic fractures indicated for primary surgical fixation between 2019 and 2022 were included. Serum laboratory tests consisting of PAB, C-reactive protein, complete blood counts, and complete metabolic panel were obtained within 24 hours of arrival.
Primary outcome measures included characterization of patient risk factors for increased intensive care unit LOS, hospital LOS, and in-hospital complications. Secondary outcome measures included characterization of patients who were stratified as "at risk" for malnutrition by PAB < 20 mg/dL and identification of complication predictors.
Fifty-one (32%) patients were stratified as "at risk" for malnutrition based on serum PAB < 20 mg/dL drawn within 24 hours of arrival. These patients had longer median hospital LOS ( < 0.001), were more likely to stay in the hospital longer than 7 days ( < 0.009) and >14 days (OR = 3.20, 95% CI 1.17-9.07, < 0.001), and had twice the amount of postoperative complications during their hospital stay ( = 0.04) than patients with PAB ≥ 20 mg/dL.
Patients with orthopaedic trauma can reliably and cost-effectively be screened and stratified for risk of malnutrition using PAB drawn with immediate admission labs.
Level III.
评估前白蛋白（PAB）作为入院时早期检测营养不良风险的预后指标，及其与骨科创伤患者院内并发症和住院时间（LOS）的相关性。
回顾性队列研究。
城市一级学术创伤中心。
患者/参与者：纳入2019年至2022年间158例年龄18岁及以上、因急性创伤性骨折需行一期手术固定的患者。在到达后24小时内进行血清实验室检查，包括PAB、C反应蛋白、全血细胞计数和全代谢组检查。
主要结局指标包括对重症监护病房住院时间延长、医院住院时间和院内并发症增加的患者风险因素进行特征描述。次要结局指标包括对PAB<20mg/dL分层为“营养不良风险”的患者进行特征描述，以及识别并发症预测因素。
51例（32%）患者根据到达后24小时内测得的血清PAB<20mg/dL被分层为“营养不良风险”。这些患者的中位住院时间更长（<0.001），更有可能住院超过7天（<0.009）和>14天（OR=3.20，95%CI 1.17-9.07，<0.001），并且住院期间术后并发症的发生率是PAB≥20mg/dL患者的两倍（=0.04）。
对于骨科创伤患者，使用入院即刻实验室检查测得的PAB可以可靠且经济高效地筛查和分层营养不良风险。
三级。
