Influence of Preoperative Nutritional Status on Surgical Outcomes of Arthroplasty in Geriatric Femoral Neck Fractures.

IF 1.6 4区医学 Q4 GERIATRICS & GERONTOLOGY

Geriatric Orthopaedic Surgery & Rehabilitation Pub Date : 2025-03-27 eCollection Date: 2025-01-01 DOI:10.1177/21514593251327914

Sarbhjit Singh Lakha Singh, Khanchana Devi Theveraja, Jade Pei Yuik Ho, Sangitaa P Palaniappan, Sanjay Raj Subramaniam, Sarbhan Singh Lakha Singh, Kunalan Ganthel

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引用次数: 0

Abstract

Background: Patients with geriatric neck of femur (NOF) fractures often have multiple medical conditions and compromised baseline nutrition, impacting arthroplasty outcomes. Indicators like BMI, albumin, hemoglobin, urea, creatinine, CRP, and HbA1c influence nutritional status and postoperative results. This study evaluates the impact of preoperative nutrition on surgical outcomes, including postoperative complications, mobility, and pain scores in geriatric femoral neck fractures.

Methods: A retrospective study of 141 geriatric patients with NOF fractures admitted to Kuala Lumpur General Hospital between 2022-2023, treated operatively, was conducted. Associations of age, gender, ethnicity, BMI, education, smoking status, comorbidity, pre-fracture mobility, American Society of Anesthesiologists (ASA) level, and perioperative nutritional parameters with post-surgical complications, mobility, and WOMAC scores 1-year post-surgery were analyzed using logistic regression.

Results: Higher BMI (AOR = 1.21, 95% CI: 1.07-1.42, P = 0.03) and ASA levels ≥2 (AOR = 2.53, 95% CI: 1.30-4.91, P = 0.01) were significant predictors of post-surgical complications. Abnormal hematological variables, including hemoglobin (AOR = 1.78, 95% CI: 1.45-2.45, P < 0.001), urea (AOR = 1.35, 95% CI: 1.15-1.60, P = 0.002), creatinine (AOR = 1.20, 95% CI: 1.00-1.52, P = 0.04), and HbA1c (AOR = 1.40, 95% CI: 1.25-1.67, P = 0.004), were also associated with complications. BMI (AOR = 1.12, 95% CI: 1.06-1.30, P = 0.049) and abnormal hematological variables, including hemoglobin (AOR = 1.99, 95% CI: 1.05-2.70, P = 0.003), urea (AOR = 1.58, 95% CI: 1.06-1.95, P = 0.006), creatinine (AOR = 1.21, 95% CI: 1.09-1.38, P = 0.048), and HbA1c (AOR = 1.98, 95% CI: 1.25-2.57, P = 0.002), were significant predictors of reduced post-surgical mobility. No significant factors were associated with WOMAC scores at 1 year.

Conclusion: Preoperative nutritional status significantly impacts outcomes in geriatric patients undergoing arthroplasty for femoral neck fractures. Comprehensive preoperative nutritional assessments are essential for improving postoperative outcomes.

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背景：老年股骨颈（NOF）骨折患者通常患有多种疾病，基础营养受到影响，从而影响关节置换术的效果。体重指数、白蛋白、血红蛋白、尿素、肌酐、CRP 和 HbA1c 等指标会影响营养状况和术后效果。本研究评估了术前营养对手术结果的影响，包括老年股骨颈骨折患者的术后并发症、活动度和疼痛评分：该研究对 2022-2023 年间吉隆坡总医院收治的 141 名老年股骨颈骨折患者进行了回顾性研究，这些患者均接受了手术治疗。采用逻辑回归法分析了年龄、性别、种族、体重指数、教育程度、吸烟状况、合并症、骨折前活动度、美国麻醉医师协会（ASA）水平和围手术期营养参数与手术后并发症、活动度和术后1年WOMAC评分的关系：较高的体重指数（AOR = 1.21，95% CI：1.07-1.42，P = 0.03）和 ASA 水平≥2（AOR = 2.53，95% CI：1.30-4.91，P = 0.01）是手术后并发症的重要预测因素。血液学变量异常，包括血红蛋白（AOR = 1.78，95% CI：1.45-2.45，P < 0.001）、尿素（AOR = 1.35，95% CI：1.15-1.60，P = 0.002）、肌酐（AOR = 1.20，95% CI：1.00-1.52，P = 0.04）和 HbA1c（AOR = 1.40，95% CI：1.25-1.67，P = 0.004）也与并发症相关。BMI（AOR = 1.12，95% CI：1.06-1.30，P = 0.049）和异常血液学变量，包括血红蛋白（AOR = 1.99，95% CI：1.05-2.70，P = 0.003）、尿素（AOR = 1.58，95% CI：1.06-1.95，P = 0.006）、肌酐（AOR = 1.21，95% CI：1.09-1.38，P = 0.048）和 HbA1c（AOR = 1.98，95% CI：1.25-2.57，P = 0.002）是手术后活动能力降低的显著预测因素。结论：术前营养状况对术后活动能力的影响非常明显：结论：术前营养状况对接受股骨颈骨折关节置换术的老年患者的预后有重要影响。全面的术前营养评估对改善术后效果至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Geriatric Orthopaedic Surgery & Rehabilitation Medicine-Rehabilitation

CiteScore

3.00

自引率

0.00%

发文量

审稿时长

9 weeks

期刊介绍： Geriatric Orthopaedic Surgery & Rehabilitation (GOS) is an open access, peer-reviewed journal that provides clinical information concerning musculoskeletal conditions affecting the aging population. GOS focuses on care of geriatric orthopaedic patients and their subsequent rehabilitation. This journal is a member of the Committee on Publication Ethics (COPE).