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Nutritional status as a predictive marker for surgical site infection in total joint arthroplasty

BACKGROUND: Surgical site infection (SSI) is considered one of the most serious complications in total joint arthroplasty (TJA). This study seeks to analyze the predictive value of preoperative and postoperative nutritional biomarkers for SSI in elective TJA. METHODOLOGY: Nutritional markers were ga...

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Autores principales: Alfargieny, Randa, Bodalal, Zuhir, Bendardaf, Riyad, El-Fadli, Mustafa, Langhi, Salem
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4637948/
https://www.ncbi.nlm.nih.gov/pubmed/26629466
http://dx.doi.org/10.4103/2231-0770.165122
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author Alfargieny, Randa
Bodalal, Zuhir
Bendardaf, Riyad
El-Fadli, Mustafa
Langhi, Salem
author_facet Alfargieny, Randa
Bodalal, Zuhir
Bendardaf, Riyad
El-Fadli, Mustafa
Langhi, Salem
author_sort Alfargieny, Randa
collection PubMed
description BACKGROUND: Surgical site infection (SSI) is considered one of the most serious complications in total joint arthroplasty (TJA). This study seeks to analyze the predictive value of preoperative and postoperative nutritional biomarkers for SSI in elective TJA. METHODOLOGY: Nutritional markers were gathered retrospectively utilizing patient's records from the orthopedics department at Benghazi Medical Center (BMC). The sample spanned cases admitted during the 20-month period between January 2012 and August 2013 and had undergone either elective total hip replacement or total knee replacement. The collected lab results included a complete blood count, total lymphocyte count (TLC), and serum albumin (S. alb.) levels. The patients were then divided into two groups based on the occurrence of an SSI. RESULTS: A total of 135 total knee (81.5%, n = 110/135) and total hip (18.5%, n = 25/135) replacements were performed at BMC during the study period. Among these cases, 57% (n = 78/135) had patient records suitable for statistical analysis. The average preoperative TLC was 2.422 ×10(3) cells/mm(3) (range = 0.8–4.7 ×10(3) cells/mm(3)) whereas that number dropped after the surgery to 1.694 ×10(3) cells/mm(3) (range = 0.6–3.8 ×10(3) cells/mm(3)). S. alb. levels showed a mean of 3.973 g/dl (range = 2.9–4.7 g/dl) preoperatively and 3.145 g/dl (range = 1.0–4.1 g/dl) postoperatively. The majority of TJA patients did not suffer any complication (67.4%, n = 91/135) while eight cases (5.9%) suffered from a superficial SSI. CONCLUSION: Preoperative S. alb. was identified as the only significant predictor for SSI (P = 0.011). Being a preventable cause of postoperative morbidity, it is recommended that the nutritional status (especially preoperative S. alb.) of TJA patients be used as a screening agent and appropriate measures be taken to avoid SSI.
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spelling pubmed-46379482015-12-01 Nutritional status as a predictive marker for surgical site infection in total joint arthroplasty Alfargieny, Randa Bodalal, Zuhir Bendardaf, Riyad El-Fadli, Mustafa Langhi, Salem Avicenna J Med Original Article BACKGROUND: Surgical site infection (SSI) is considered one of the most serious complications in total joint arthroplasty (TJA). This study seeks to analyze the predictive value of preoperative and postoperative nutritional biomarkers for SSI in elective TJA. METHODOLOGY: Nutritional markers were gathered retrospectively utilizing patient's records from the orthopedics department at Benghazi Medical Center (BMC). The sample spanned cases admitted during the 20-month period between January 2012 and August 2013 and had undergone either elective total hip replacement or total knee replacement. The collected lab results included a complete blood count, total lymphocyte count (TLC), and serum albumin (S. alb.) levels. The patients were then divided into two groups based on the occurrence of an SSI. RESULTS: A total of 135 total knee (81.5%, n = 110/135) and total hip (18.5%, n = 25/135) replacements were performed at BMC during the study period. Among these cases, 57% (n = 78/135) had patient records suitable for statistical analysis. The average preoperative TLC was 2.422 ×10(3) cells/mm(3) (range = 0.8–4.7 ×10(3) cells/mm(3)) whereas that number dropped after the surgery to 1.694 ×10(3) cells/mm(3) (range = 0.6–3.8 ×10(3) cells/mm(3)). S. alb. levels showed a mean of 3.973 g/dl (range = 2.9–4.7 g/dl) preoperatively and 3.145 g/dl (range = 1.0–4.1 g/dl) postoperatively. The majority of TJA patients did not suffer any complication (67.4%, n = 91/135) while eight cases (5.9%) suffered from a superficial SSI. CONCLUSION: Preoperative S. alb. was identified as the only significant predictor for SSI (P = 0.011). Being a preventable cause of postoperative morbidity, it is recommended that the nutritional status (especially preoperative S. alb.) of TJA patients be used as a screening agent and appropriate measures be taken to avoid SSI. Medknow Publications & Media Pvt Ltd 2015 /pmc/articles/PMC4637948/ /pubmed/26629466 http://dx.doi.org/10.4103/2231-0770.165122 Text en Copyright: © Avicenna Journal of Medicine http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.
spellingShingle Original Article
Alfargieny, Randa
Bodalal, Zuhir
Bendardaf, Riyad
El-Fadli, Mustafa
Langhi, Salem
Nutritional status as a predictive marker for surgical site infection in total joint arthroplasty
title Nutritional status as a predictive marker for surgical site infection in total joint arthroplasty
title_full Nutritional status as a predictive marker for surgical site infection in total joint arthroplasty
title_fullStr Nutritional status as a predictive marker for surgical site infection in total joint arthroplasty
title_full_unstemmed Nutritional status as a predictive marker for surgical site infection in total joint arthroplasty
title_short Nutritional status as a predictive marker for surgical site infection in total joint arthroplasty
title_sort nutritional status as a predictive marker for surgical site infection in total joint arthroplasty
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4637948/
https://www.ncbi.nlm.nih.gov/pubmed/26629466
http://dx.doi.org/10.4103/2231-0770.165122
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