Albumin, Prealbumin, and Transferrin May Be Predictive of Wound Complications following Total Knee Arthroplasty
Autor: | Nipun Sodhi, Tsun Yee Law, Martin W. Roche, Jennifer Kurowicki, Spencer Summers, Karim G. Sabeh, Leah Elson, Samuel Rosas, Michael A. Mont |
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Rok vydání: | 2018 |
Předmět: |
Male
medicine.medical_specialty Databases Factual Joint replacement medicine.medical_treatment Nutritional Status 03 medical and health sciences 0302 clinical medicine Predictive Value of Tests Risk Factors Surgical Wound Dehiscence Humans Prealbumin Surgical Wound Infection Medicine Orthopedics and Sports Medicine 030212 general & internal medicine Arthroplasty Replacement Knee Serum Albumin Aged Retrospective Studies 030222 orthopedics business.industry Malnutrition Transferrin Retrospective cohort study Odds ratio Middle Aged Arthroplasty Surgery Predictive value of tests Concomitant Current Procedural Terminology Female Complication business Biomarkers |
Zdroj: | The Journal of Knee Surgery. 31:946-951 |
ISSN: | 1938-2480 1538-8506 |
DOI: | 10.1055/s-0038-1672122 |
Popis: | Nutritional status has become increasingly important in optimizing surgical outcomes and preventing postoperative infection and wound complications. However, currently, there is a paucity in the orthopaedics literature investigating the relationship between nutritional status and wound complications following total knee arthroplasty (TKA). Therefore, the purpose of this study was to determine the prevalence of (1) postoperative infections, (2) wound complications, (3) concomitant infection with wound (CoIW) complication, and (4) infection followed by wound complication by using (1) albumin, (2) prealbumin, and (3) transferrin levels as indicators of nutritional status. These four different outcome measures were chosen as they are encountered commonly in daily clinical practice. A retrospective review of a national private payer database for patients who underwent TKA with postoperative infections and wound complications stratified by preoperative serum albumin (normal: 3.5–5 g/dL), prealbumin (normal: 16–35 mg/dL), and transferrin levels (normal: 200–360 mg/dL) between 2007 and 2015 was conducted. Patients were identified by Current Procedural Terminology (CPT), International Classification of Disease, ninth revision (ICD-9) codes, and Logical Observation Identifiers Names and Codes (LOINC). Linear regression was performed to evaluate changes over times. Yearly rates of infection, as well as a correlation and odds ratio analysis of nutritional laboratory values to postoperative complications, were also performed. Our query returned a total of 161,625 TKAs, of which 11,047 (7%) had postoperative wound complications, 18,403 (11%) had infections, 6,296 (34%) had CoIW, and 4,877 (4%) patients with infection developed wound complications. Albumin was the most commonly ordered laboratory test when assessing complications (96%). Wound complications, infections, CoIW, and infection with wound complications after were higher in those below the normal range: albumin |
Databáze: | OpenAIRE |
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