» Articles » PMID: 39713258

Severe Malnutrition Predicts Early Postoperative Complications in Aseptic Revision Total Shoulder Arthroplasty

Overview
Journal Shoulder Elbow
Date 2024 Dec 23
PMID 39713258
Authors
Affiliations
Soon will be listed here.
Abstract

Background: This study investigates the association between the Geriatric Nutritional Risk Index (GNRI), a simple readily available measure of malnutrition risk, and 30-day postoperative complications following revision total shoulder arthroplasty (TSA).

Methods: The American College of Surgeons National Surgical Quality Improvement Program database was queried for all patients who underwent TSA between 2015 and 2022. The study population was divided into three groups based on preoperative GNRI: normal/reference (GNRI > 98), moderate malnutrition (92 ≤ GNRI ≤ 98), and severe malnutrition (GNRI < 92). Logistic regression analysis was conducted to investigate the connection between preoperative GNRI and postoperative complications.

Results: Compared to normal nutrition, moderate malnutrition was not independently associated with postoperative complications. Compared to normal nutrition, severe malnutrition was independently associated with a greater likelihood of experiencing any complication (odds ratio (OR) 3.08, 95% confidence interval (CI) 1.80-5.27; < 0.001), blood transfusions (OR 3.68, 95% CI 1.40-9.66; = 0.008), non-home discharge (OR 2.99, 95% CI 1.50-5.98; = 0.002), and length of stay >2 days (OR 3.10, 95% CI 1.77-5.42; < 0.001).

Discussion: Severe malnutrition based on GNRI is a predictor of early complications following revision TSA, however moderate malnutrition is not.

References
1.
Farley K, Wilson J, Kumar A, Gottschalk M, Daly C, Sanchez-Sotelo J . Prevalence of Shoulder Arthroplasty in the United States and the Increasing Burden of Revision Shoulder Arthroplasty. JB JS Open Access. 2021; 6(3). PMC: 8280071. DOI: 10.2106/JBJS.OA.20.00156. View

2.
Wells D, Holt A, Smith R, Brolin T, Azar F, Throckmorton T . Tobacco use predicts a more difficult episode of care after anatomic total shoulder arthroplasty. J Shoulder Elbow Surg. 2017; 27(1):23-28. DOI: 10.1016/j.jse.2017.06.033. View

3.
Kim M, Ling K, Nazemi A, Tantone R, Kashanchi K, Lung B . Abnormal preoperative platelet count may predict postoperative complications following shoulder arthroplasty. JSES Int. 2022; 6(6):935-941. PMC: 9637646. DOI: 10.1016/j.jseint.2022.06.008. View

4.
Lopes K, Yamaji N, Rahman M, Suto M, Takemoto Y, Garcia-Casal M . Nutrition-specific interventions for preventing and controlling anaemia throughout the life cycle: an overview of systematic reviews. Cochrane Database Syst Rev. 2021; 9:CD013092. PMC: 8464655. DOI: 10.1002/14651858.CD013092.pub2. View

5.
Williams D, Molinger J, Wischmeyer P . The malnourished surgery patient: a silent epidemic in perioperative outcomes?. Curr Opin Anaesthesiol. 2019; 32(3):405-411. PMC: 6760866. DOI: 10.1097/ACO.0000000000000722. View