UNASSIGNED: The American College of Surgeons National Surgical Quality Improvement Program database was queried for all patients ≥65 who underwent aseptic rTHA between 2015 and 2021. The final study population (n = 7119) was divided into 3 groups based on preoperative GNRI: normal/reference (GNRI >98) (n = 4342), moderate malnutrition (92 ≤ GNRI ≤98) (n = 1367), and severe malnutrition (GNRI <92) (n = 1410). Multivariate logistic regression analysis was conducted to investigate the association between preoperative GNRI and 30-day postoperative complications.
UNASSIGNED: After controlling for significant covariates, the risk of experiencing any postoperative complications was significantly higher with both moderate (odds ratio [OR] 2.08, P < .001) and severe malnutrition (OR 8.79, P < .001). Specifically, moderate malnutrition was independently and significantly associated with deep vein thrombosis (OR 1.01, P = .044), blood transfusions (OR 1.78, P < .001), nonhome discharge (OR 1.83, P < .001), readmission (OR 1.27, P = .035), length of stay >2 days (OR 1.98, P < .001), and periprosthetic fracture (OR 1.54, P = .020). Severe malnutrition was independently and significantly associated with sepsis (OR 3.67, P < .001), septic shock (OR 3.75, P = .002), pneumonia (OR 2.73, P < .001), urinary tract infection (OR 2.04, P = .002), deep vein thrombosis (OR 1.01, P = .001), pulmonary embolism (OR 2.47, P = .019), acute renal failure (OR 8.44, P = .011), blood transfusions (OR 2.78, P < .001), surgical site infection (OR 2.59, P < .001), nonhome discharge (OR 3.36, P < .001), readmission (OR 1.69, P < .001), unplanned reoperation (OR 1.97, P < .001), length of stay >2 days (OR 5.41, P < .001), periprosthetic fractures (OR 1.61, P = .015), and mortality (OR 2.63, P < .001).
UNASSIGNED: Malnutrition has strong predictive value for short-term postoperative complications and has potential as an adjunctive risk stratification tool for geriatric patients undergoing rTHA.
■美国外科医生学会国家外科质量改善计划数据库查询了2015年至2021年期间接受无菌rTHA的所有≥65的患者。最终研究人群(n=7119)根据术前GNRI分为3组:正常/参考(GNRI>98)(n=4342),中度营养不良(92≤GNRI≤98)(n=1367),严重营养不良(GNRI<92)(n=1410)。采用多因素logistic回归分析探讨术前GNRI与术后30d并发症的关系。
■在控制了显著的协变量后,中度营养不良(比值比[OR]2.08,P<.001)和重度营养不良(OR8.79,P<.001)患者发生任何术后并发症的风险均显著较高.具体来说,中度营养不良与深静脉血栓形成独立且显著相关(OR1.01,P=.044),输血(OR1.78,P<.001),非家庭放电(OR1.83,P<.001),再入院(OR1.27,P=.035),住院时间>2天(OR1.98,P<.001),和假体周围骨折(OR1.54,P=0.020)。严重营养不良与脓毒症独立且显著相关(OR3.67,P<.001),感染性休克(OR3.75,P=0.002),肺炎(OR2.73,P<.001),尿路感染(OR2.04,P=0.002),深静脉血栓形成(OR1.01,P=.001),肺栓塞(OR2.47,P=0.019),急性肾功能衰竭(OR8.44,P=.011),输血(OR2.78,P<.001),手术部位感染(OR2.59,P<.001),非家庭放电(OR3.36,P<.001),再入院(OR1.69,P<.001),计划外再操作(OR1.97,P<.001),住院时间>2天(OR5.41,P<.001),假体周围骨折(OR1.61,P=0.015),和死亡率(OR2.63,P<.001)。
■营养不良对短期术后并发症有很强的预测价值,并且有可能作为接受rTHA的老年患者的辅助风险分层工具。