Effects of Malnutrition on Perioperative Outcomes of Total Hip Arthroplasty: A Systematic Review and Meta-Analysis

IF 1.5 Q3 ORTHOPEDICS

Arthroplasty Today Pub Date : 2025-04-01 DOI:10.1016/j.artd.2025.101667

Adam Aziz BA , James B. Bluhm BS , Tyler K. Williamson DO , Cameron Atkison MD , Andrew Eck MD , Chance Moore MD , Frank A. Buttacavoli MD

{"title":"Effects of Malnutrition on Perioperative Outcomes of Total Hip Arthroplasty: A Systematic Review and Meta-Analysis","authors":"Adam Aziz BA , James B. Bluhm BS , Tyler K. Williamson DO , Cameron Atkison MD , Andrew Eck MD , Chance Moore MD , Frank A. Buttacavoli MD","doi":"10.1016/j.artd.2025.101667","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Malnutrition can play a significant role in wound healing, immune response, and conditioning. The purpose of this review is to characterize definitions of malnutrition in total hip arthroplasty (THA) and analyze its effects on postoperative outcomes.</div></div><div><h3>Methods</h3><div>A systematic search was conducted using iterations of the key terms “total hip arthroplasty” and “malnutrition.” Human studies describing malnutrition in patients undergoing primary THA for either traumatic or elective indications were included. Using the SPSS meta-analysis binary and continuous model function, the mean effect size estimate (MSE) or Cohen’s d (Cd) statistic with 95% confidence interval was reported.</div></div><div><h3>Results</h3><div>This search yielded a total of 555 studies, of which 9 articles comprising 495,657 patients undergoing primary THA were included, characterizing 16,895 patients (3.4%) as malnourished. Studies characterized malnutrition as albumin <3.5 g/dL (n = 7) and total lymphocyte count <1500 (n = 1). Malnutrition was associated with an increased rate of nonhome discharge (MSE = 0.81, [0.55-1.07]) and likelihood of readmission (MSE = 0.86, [0.75-0.97]). Malnutrition at the time of surgery was also associated with increased rates of any complication (MSE = 1.01, [0.46-1.57]), wound complications (MSE = 1.04, [0.72-1.36]), pulmonary complications (MSE = 1.54, [1.29-1.78]), need for transfusion (MSE = 0.75, [0.54-0.96]), periprosthetic fracture (MSE = 0.65, [0.47-0.82]), reoperation (MSE = 0.72, [0.58-0.86]), and perioperative mortality (MSE = 2.05, [1.76-2.33]).</div></div><div><h3>Conclusions</h3><div>Malnutrition was found to have significant associations with complications and disposition following THA. The findings from this meta-analysis provide support for further investigation into perioperative nutritional supplementation strategies for surgeons to optimize at-risk patients prior to THA.</div></div><div><h3>Level of Evidence</h3><div>III.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"33 ","pages":"Article 101667"},"PeriodicalIF":1.5000,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Arthroplasty Today","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2352344125000548","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ORTHOPEDICS","Score":null,"Total":0}

引用次数: 0

Abstract

Background

Malnutrition can play a significant role in wound healing, immune response, and conditioning. The purpose of this review is to characterize definitions of malnutrition in total hip arthroplasty (THA) and analyze its effects on postoperative outcomes.

Methods

A systematic search was conducted using iterations of the key terms “total hip arthroplasty” and “malnutrition.” Human studies describing malnutrition in patients undergoing primary THA for either traumatic or elective indications were included. Using the SPSS meta-analysis binary and continuous model function, the mean effect size estimate (MSE) or Cohen’s d (Cd) statistic with 95% confidence interval was reported.

Results

This search yielded a total of 555 studies, of which 9 articles comprising 495,657 patients undergoing primary THA were included, characterizing 16,895 patients (3.4%) as malnourished. Studies characterized malnutrition as albumin <3.5 g/dL (n = 7) and total lymphocyte count <1500 (n = 1). Malnutrition was associated with an increased rate of nonhome discharge (MSE = 0.81, [0.55-1.07]) and likelihood of readmission (MSE = 0.86, [0.75-0.97]). Malnutrition at the time of surgery was also associated with increased rates of any complication (MSE = 1.01, [0.46-1.57]), wound complications (MSE = 1.04, [0.72-1.36]), pulmonary complications (MSE = 1.54, [1.29-1.78]), need for transfusion (MSE = 0.75, [0.54-0.96]), periprosthetic fracture (MSE = 0.65, [0.47-0.82]), reoperation (MSE = 0.72, [0.58-0.86]), and perioperative mortality (MSE = 2.05, [1.76-2.33]).

Conclusions

Malnutrition was found to have significant associations with complications and disposition following THA. The findings from this meta-analysis provide support for further investigation into perioperative nutritional supplementation strategies for surgeons to optimize at-risk patients prior to THA.

Level of Evidence

III.

查看原文本刊更多论文

求助全文

约1分钟内获得全文求助全文

来源期刊

Arthroplasty Today Medicine-Surgery

CiteScore

2.90

自引率

0.00%

发文量

258

审稿时长

40 weeks

期刊介绍： Arthroplasty Today is a companion journal to the Journal of Arthroplasty. The journal Arthroplasty Today brings together the clinical and scientific foundations for joint replacement of the hip and knee in an open-access, online format. Arthroplasty Today solicits manuscripts of the highest quality from all areas of scientific endeavor that relate to joint replacement or the treatment of its complications, including those dealing with patient outcomes, economic and policy issues, prosthetic design, biomechanics, biomaterials, and biologic response to arthroplasty. The journal focuses on case reports. It is the purpose of Arthroplasty Today to present material to practicing orthopaedic surgeons that will keep them abreast of developments in the field, prove useful in the care of patients, and aid in understanding the scientific foundation of this subspecialty area of joint replacement. The international members of the Editorial Board provide a worldwide perspective for the journal''s area of interest. Their participation ensures that each issue of Arthroplasty Today provides the reader with timely, peer-reviewed articles of the highest quality.