Perioperative Immunonutrition in Elderly Patients Undergoing Total Hip and Knee Arthroplasty: Impact on Postoperative Outcomes

Overview

Journal JPEN J Parenter Enteral Nutr

Publisher Wiley

Specialty Nutritional Sciences

Date 2020 Oct 12

PMID 33044001

Citations 8

Authors

Thiago Jose Martins Goncalves

Sandra Elisa Adami Batista Goncalves

Natassia Nava

Valeria Conceicao Jorge

Andrea Massone Okawa

Vanessa Azevedo Rocha

Luciana Carolina Henrique Forato

Vicky Akemi Onizuca Furuya

Sandra Salvador Martins

Daniel Oksman

Affiliations

Soon will be listed here.

Abstract

Background: Arthroplasties in elderly patients are surgeries performed to ensure their quality of life. Perioperative care with specific nutrients can improve nutrition status and metabolic response to orthopedic surgeries, such as total knee arthroplasty (TKA) and total hip arthroplasty (THA).

Methods: Retrospective study with elderly patients divided into 2 groups: control and immunonutrition. The immunonutrition group was instructed to start oral intake of the nutrition supplement 5 days before and to resume it 5 days after arthroplasty (200 mL, 3 times per day). The following were analyzed as primary and secondary outcomes: length of stay (LOS), infectious and noninfectious complications, need for intensive care unit (ICU), transfusion requirement, and C-reactive protein.

Results: A total of 3015 elderly patients met the inclusion criteria: control group (n = 1398) and immunonutrition group (n = 1617). Overall, 81.2% were women and mean age was 72.6 ± 6.9 years. Immunonutrition group had a shorter LOS in hours (32.0 ± 19.4 vs 56.0 ± 26.4; P < .001) and lower rates of infectious complications (2.2% vs 4.6%; P < .001). Noninfectious complications and need for ICU also had lower rates in the immunonutrition group. In the logistic regression analysis, immunonutrition reduced the chance of infectious complications by 55% (odds ratio [OR], 0.45; 95% CI, 0.30-0.68; P < .001) even after adjusting for variables (OR, 0.45; 95% CI, 0.28-0.71; P < .001).

Conclusion: Perioperative immunonutrition in elderly patients undergoing THA or TKA may shorten postoperative LOS and reduce infectious and noninfectious complications and transfusion requirement.

Citing Articles

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The safety of preoperative carbohydrate drinks in extremely elderly patients assessed by gastric ultrasonography: a randomized controlled trial.

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Effect of White Noise Intervention Combined with Multi-dimensional Nursing Mode on Sleep Quality and Incidence of Nosocomial Infection in Patients Undergoing Hip Replacement.

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Marie-Hardy L, Khalife M, Pietton R, Rollet M, Boissiere L, Cohen-Bittan J Gerontol Geriatr Med. 2024; 10:23337214231225841.

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