Journal article
Impact of Frailty and Malnutrition on Outcomes After Surgical Fixation of Lower Extremity Fractures in Young Patients
Journal of orthopaedic trauma, Vol.35(4), pp.E126-E133
04/01/2021
DOI: 10.1097/BOT.0000000000001952
PMID: 32910628
Abstract
Objectives: Evaluate the relationship of nutrition parameters and the modified frailty index (mFI) on postsurgical complications within a young patient population sustaining lower extremity orthopaedic trauma. Design: Retrospective observational cohort study. Setting: Urban, American College of Surgeons-Verified, Level-1, Trauma Center. Patients/Participants: Seventeen-thousand one hundred nine adult patients under the age of 65 sustaining lower extremity fractures undergoing operative intervention from 2006 to 2018. Main Outcome Measures: On admission, mFI and albumin levels were obtained, as well as complication data. Statistical analysis was used to analyze the association between frailty, malnutrition, and postoperative complications. Patients were stratified, healthy (mFI <= 1, albumin >= 3.5 g/dL), malnourished (mFI <= 1, albumin <3.5 g/dL), frail (mFI >= 2, albumin >= 3.5 g/dL), and frail and malnourished (mFI >= 2, albumin <3.5 g/dL). Results: 60.4% of patients were healthy, 18.8% were malnourished, 11.7% were frail, and 9.0% were frail and malnourished. Frailty and/or malnourishment on admission predicted significantly higher odds of postoperative complications and mortality when compared with healthy patients. Frailty and malnourishment in conjunction predicted a significantly higher odds ratio of 1.46 (1.22-1.75) for developing postoperative complications when compared with the only malnourished. This was also observed when compared with the only frail (odd ratio: 1.61, P < 0.001); however, there was also a 2.72 (P < 0.001) increased odds of mortality. Conclusions: Frailty and malnutrition in conjunction predicts a subset of patients with a higher risk of postoperative complications beyond that of frailty or malnutrition in isolation. Identification of these physiological states on admission allows for interventional opportunities during hospitalization.
Details
- Title: Subtitle
- Impact of Frailty and Malnutrition on Outcomes After Surgical Fixation of Lower Extremity Fractures in Young Patients
- Creators
- Huai Ming Phen - Emory UniversityCorey Jones - Emory UniversityVictoria G. Kravets - Emory Univ, Sch Med, Atlanta, GA USAKevin Xavier Farley - Emory Univ, Sch Med, Atlanta, GA USAAndrew M. Schwartz - Emory UniversityJacob M. Wilson - Emory Univ, Sch Med, Atlanta, GA USAMara L. Schenker - Emory University
- Resource Type
- Journal article
- Publication Details
- Journal of orthopaedic trauma, Vol.35(4), pp.E126-E133
- Publisher
- Lippincott Williams & Wilkins
- DOI
- 10.1097/BOT.0000000000001952
- PMID
- 32910628
- ISSN
- 0890-5339
- eISSN
- 1531-2291
- Number of pages
- 8
- Language
- English
- Date published
- 04/01/2021
- Academic Unit
- Orthopedics and Rehabilitation
- Record Identifier
- 9984303973002771
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