Saturday, February 6, 2016

Malnutrition (low preoperative albumin concentration) is associated with shoulder arthroplasty complications

Malnutrition: a marker for increased complications, mortality, and length of stay after total shoulder arthroplasty.

These authors searched the American College of Surgeons National Surgical Quality Improvement Program database was queried for TSA cases from 2005 to 2013. 

They compared rates of postoperative complications for patients with and without malnutrition (defined as preoperative albumin concentration of <3.5 g/dL.) among 1681 patients with preoperative albumin measurements available 7.6% of which were malnourished.

Propensity-adjusted multivariable logistic regression demonstrated that malnutrition was significantly associated with postoperative transfusion (odds ratio, 2.49), extended LOS (odds ratio, 1.69), and death within 30 days of surgery (odds ratio, 18.09).

Comment: From the table below, it can be seen that the patients with low albumin were sicker in many different regards. 

In that shoulder arthroplasty is an elective procedure, we wonder why surgery was performed on so many patients with poor health. In view of these data, we are informed that non-operative management requires serious consideration in these individuals.


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