Hypoalbuminemia Independently Predicts Surgical Site Infection, Pneumonia, Length of Stay, and Readmission After Total Joint Arthroplasty

Journal of Arthroplasty

Volumn 31, Issue 1, 2016, Pages 15-21

  Bohl, Daniel D ^a   Shen, Mary R ^b   Kayupov, Erdan ^a   Della Valle, Craig J ^a  

^a RUSH UNIVERSITY MEDICAL CENTER   (United States)

^b UNIVERSITY OF NORTH CAROLINA SCHOOL OF MEDICINE   (United States)

Author keywords

Hypoalbuminemia; Malnutrition; Periprosthetic joint infection; Pneumonia; Surgical site infection; Total joint arthroplasty

Indexed keywords

ALBUMIN; BIOLOGICAL MARKER; SERUM ALBUMIN;

ADULT; AGED; ALBUMIN BLOOD LEVEL; ANEMIA; ARTHROPLASTY; ARTICLE; BODY MASS; CHRONIC OBSTRUCTIVE LUNG DISEASE; COMPARATIVE STUDY; CONTROLLED STUDY; DISEASE ASSOCIATION; DYSPNEA; END STAGE RENAL DISEASE; FEMALE; GROUPS BY AGE; HIGH RISK PATIENT; HOSPITAL READMISSION; HUMAN; HYPOALBUMINEMIA; INSULIN DEPENDENT DIABETES MELLITUS; LENGTH OF STAY; MAJOR CLINICAL STUDY; MALE; MIDDLE AGED; OUTCOME ASSESSMENT; PNEUMONIA; PREDICTION; RETROSPECTIVE STUDY; SEX DIFFERENCE; SMOKING; SURGICAL INFECTION; TOTAL HIP PROSTHESIS; TOTAL JOINT ARTHROPLSTY; TOTAL KNEE REPLACEMENT; VERY ELDERLY; ADOLESCENT; ADVERSE EFFECTS; BLOOD; COMPLICATION; ELECTIVE SURGERY; KNEE REPLACEMENT; MALNUTRITION; METABOLISM; PREOPERATIVE PERIOD; REPLACEMENT ARTHROPLASTY; RISK FACTOR; STATISTICS AND NUMERICAL DATA; SURGICAL WOUND INFECTION; YOUNG ADULT;

ADOLESCENT; ADULT; AGED; AGED, 80 AND OVER; ARTHROPLASTY, REPLACEMENT; ARTHROPLASTY, REPLACEMENT, KNEE; BIOMARKERS; ELECTIVE SURGICAL PROCEDURES; FEMALE; HUMANS; HYPOALBUMINEMIA; LENGTH OF STAY; MALE; MALNUTRITION; MIDDLE AGED; PATIENT READMISSION; PNEUMONIA; PREOPERATIVE PERIOD; RETROSPECTIVE STUDIES; RISK FACTORS; SERUM ALBUMIN; SURGICAL WOUND INFECTION; YOUNG ADULT;

EID: 84953839652     PISSN: 08835403     EISSN: 15328406     Source Type: Journal    
DOI: 10.1016/j.arth.2015.08.028     Document Type: Article

References (49)

1. Fingar K.R., Stocks C., Weiss A.J., et al. Most frequent operating room procedures performed in U.S. hospitals, 2003-2012. Agency for Healthcare Research and Quality 2014.
2. Kurtz S., Ong K., Lau E., et al. Projections of primary and revision hip and knee arthroplasty in the United States from 2005 to 2030. J Bone Joint Surg Am 2007, 89(4):780.
3. Pulido L., Parvizi J., Macgibeny M., et al. In hospital complications after total joint arthroplasty. J Arthroplast 2008, 23(6):139.
4. Belmont P.J., Goodman G.P., Waterman B.R., et al. Thirty-day postoperative complications and mortality following total knee arthroplasty: incidence and risk factors among a national sample of 15,321 patients. J Bone Joint Surg Am 2014, 96(1):20.
5. Belmont P.J., Goodman G.P., Hamilton W., et al. Morbidity and mortality in the thirty-day period following total hip arthroplasty: risk factors and incidence. J Arthroplast 2014, 29(10):2025.
6. Illingworth K.D., El Bitar Y.F., Banerjee D., et al. Inpatient mortality after primary total hip arthroplasty: analysis from the National Inpatient Sample Database. J Arthroplast 2014, 30(3):369-373.
7. Cross M.B., Yi P.H., Thomas C.F., et al. Evaluation of malnutrition in orthopaedic surgery. J Am Acad Orthop Surg 2014, 22(3):193.
8. Russell M., McAdams M., Matarese L., et al. Laboratory monitoring of nutritional status. Contemporary nutrition support practice: a clinical guide 1998, 47.
9. Font-Vizcarra L., Lozano L., Rios J., et al. Preoperative nutritional status and post-operative infection in total knee replacements: a prospective study of 213 patients. Int J Artif Organs 2011, 34(9):876.
10. Yi P.H., Frank R.M., Vann E., et al. Is potential malnutrition associated with septic failure and acute infection after revision total joint arthroplasty?. Clin Orthop Relat Res 2015, 473(1):175.
11. Huang R., Greenky M., Kerr G.J., et al. The effect of malnutrition on patients undergoing elective joint arthroplasty. J Arthroplast 2013, 28(8):21.
12. Maier G., Horas K., Seeger J., et al. Is there an association between periprosthetic joint infection and low vitamin D levels?. Int Orthop 2014, 38(7):1499.
13. Peersman G., Laskin R., Davis J., et al. Infection in total knee replacement: a retrospective review of 6489 total knee replacements. Clin Orthop Relat Res 2001, 392:15.
14. Del Savio G.C., Zelicof S.B., Wexler L.M., et al. Preoperative nutritional status and outcome of elective total hip replacement. Clin Orthop Relat Res 1996, 326:153.
15. Gherini S., Vaughn B.K., Lombardi A.V., et al. Delayed wound healing and nutritional deficiencies after total hip arthroplasty. Clin Orthop Relat Res 1993, 293:188.
16. Greene K.A., Wilde A.H., Stulberg B.N. Preoperative nutritional status of total joint patients. Relationship to postoperative wound complications. J Arthroplasty 1991, 6(4):321.
17. Jaberi F.M., Parvizi J., Haytmanek C.T., et al. Procrastination of wound drainage and malnutrition affect the outcome of joint arthroplasty. Clin Orthop Relat Res 2008, 466(6):1368.
18. Pratt W.B., Veitch J.M., McRoberts R.L. Nutritional status of orthopedic patients with surgical complications. Clin Orthop Relat Res 1981, 155:81.
19. American College of Surgeons National Surgical Quality Improvement Program User Guide for the 2013 Participant Use Data File 2014, [Available at: http://www.acsnsqip.org. Accessed 2014 Dec].
20. Chitale R., Campbell P.G., Yadla S., et al. International Classification of Disease Clinical Modification 9 modeling of a patient comorbidity score predicts incidence of perioperative complications in a nationwide inpatient sample assessment of complications in spine surgery. J Spinal Disord Tech 2012, 28(4):126-133.
21. Zou G. A modified Poisson regression approach to prospective studies with binary data. Am J Epidemiol 2004, 159(7):702.
22. Seibert D.J. Pathophysiology of surgical site infection in total hip arthroplasty. Am J Infect Control 1999, 27(6):536.
23. Bohl D.D., Basques B.A., Golinvaux N.S., et al. Extramedullary compared with intramedullary implants for intertrochanteric hip fractures: thirty-day outcomes of 4432 procedures from the ACS NSQIP database. J Bone Joint Surg Am 1871, 96(22):2014.
24. Bohl D.D., Fu M.C., Golinvaux N.S., et al. The "July effect" in primary total hip and knee arthroplasty: analysis of 21,434 cases from the ACS-NSQIP database. J Arthroplast 2014, 29(7):1332.
25. Duchman K.R., Gao Y., Pugely A.J., et al. Differences in short-term complications between unicompartmental and total knee arthroplasty: a propensity score matched analysis. J Bone Joint Surg Am 2014, 96(16):1387.
26. Shamji M.F., Parker S., Cook C., et al. Impact of body habitus on perioperative morbidity associated with fusion of the thoracolumbar and lumbar spine. Neurosurgery 2009, 65(3):490.
27. Rana A.J., Bozic K.J. Bundled payments in orthopaedics. Clin Orthop Relat Res 2015, 473(2):422.
28. Lucas D.J., Haider A., Haut E., et al. Assessing readmission after general, vascular, and thoracic surgery using ACS-NSQIP. Ann Surg 2013, 258(3):430.
29. Lucas D.J., Pawlik T.M. Readmission after surgery. Adv Surg 2014, 48:185.
30. Bozic K.J., Ward L., Vail T.P., et al. Bundled payments in total joint arthroplasty: targeting opportunities for quality improvement and cost reduction. Clin Orthop Relat Res 2014, 472(1):188.
31. Clement R.C., Kheir M.M., Derman P.B., et al. What are the economic consequences of unplanned readmissions after TKA?. Clin Orthop Relat Res 2014, 472(10):3134.
32. Mednick R.E., Alvi H.M., Krishnan V., et al. Factors affecting readmission rates following primary total hip arthroplasty. J Bone Joint Surg Am 2014, 96(14):1201.
33. Dempsey D.T., Mullen J.L., Buzby G.P. The link between nutritional status and clinical outcome: can nutritional intervention modify it?. Am J Clin Nutr 1988, 47(2 Suppl.):352.
34. Evans D.C., Martindale R.G., Kiraly L.N., et al. Nutrition optimization prior to surgery. Nutr Clin Pract 2014, 29(1):10.
35. Jie B., Jiang Z.M., Nolan M.T., et al. Impact of preoperative nutritional support on clinical outcome in abdominal surgical patients at nutritional risk. Nutrition 2012, 28(10):1022.
36. Delmi M., Rapin C.H., Bengoa J.M., et al. Dietary supplementation in elderly patients with fractured neck of the femur. Lancet 1990, 335(8696):1013.
37. Eneroth M., Olsson U.B., Thorngren K.G. Nutritional supplementation decreases hip fracture-related complications. Clin Orthop Relat Res 2006, 451:212.
38. Vanek V.W. The use of serum albumin as a prognostic or nutritional marker and the pros and cons of IV albumin therapy. Nutr Clin Pract 1998, 13(3):110.
39. Schilling P.L., Hallstrom B.R., Birkmeyer J.D., et al. Prioritizing perioperative quality improvement in orthopaedic surgery. J Bone Joint Surg Am 1884, 92(9):2010.
40. Molina C.S., Thakore R.V., Blumer A., et al. Use of the National Surgical Quality Improvement Program in orthopaedic surgery. Clin Orthop Relat Res 2014, 473(5):1574-1581.
41. Ingraham A.M., Richards K.E., Hall B.L., et al. Quality improvement in surgery: the American College of Surgeons National Surgical Quality Improvement Program approach. Adv Surg 2010, 44:251.
42. Ghaferi A.A., Birkmeyer J.D., Dimick J.B. Variation in hospital mortality associated with inpatient surgery. N Engl J Med 2009, 361(14):1368.
43. Shiloach M., Frencher S.K., Steeger J.E., et al. Toward robust information: data quality and inter-rater reliability in the American College of Surgeons National Surgical Quality Improvement Program. J Am Coll Surg 2010, 210(1):6.
44. Bohl D.D., Russo G.S., Basques B.A., et al. Variations in data collection methods between national databases affect study results: a comparison of the nationwide inpatient sample and National Surgical Quality Improvement Program databases for lumbar spine fusion procedures. J Bone Joint Surg Am 2014, 96(23):e193.
45. Linn B.S. Delayed hypersensitivity skin testing in nutritional assessment. Am Surg 1987, 53(11):628.
46. Don B.R., Kaysen G. Serum albumin: relationship to inflammation and nutrition. Semin Dial 2004, 17(6):432.
47. Fuhrman M.P. The albumin-nutrition connection: separating myth from fact. Nutrition 2002, 18((2):199.
48. Reeds P.J., Laditan A.A. Serum albumin and transferrin protein-energy malnutrition. Their use in the assessment of marginal undernutrition and the prognosis of severe undernutrition. Br J Nutr 1976, 36(2):255.
49. Moshage H.J., Janssen J.A., Franssen J.H., et al. Study of the molecular mechanism of decreased liver synthesis of albumin in inflammation. J Clin Invest 1987, 79(6):1635.