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Hypoalbuminemia is an Independent Predictor of 30-Day Postoperative Complications Following Surgical Fixation of Ankle Fractures

CATEGORY: Basic Sciences/Biologics; Trauma; Other INTRODUCTION/PURPOSE: Malnutrition is known to be negatively associated with outcomes after multiple orthopedic procedures. We hypothesized that admission albumin levels, as a maker for malnutrition, would correlate with postoperative outcomes. The p...

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Autores principales: Kukowski, Nathan, Wilson, Jacob M., Bariteau, Jason T., Staley, Christopher A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8702773/
http://dx.doi.org/10.1177/2473011420S00307
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author Kukowski, Nathan
Wilson, Jacob M.
Bariteau, Jason T.
Staley, Christopher A.
author_facet Kukowski, Nathan
Wilson, Jacob M.
Bariteau, Jason T.
Staley, Christopher A.
author_sort Kukowski, Nathan
collection PubMed
description CATEGORY: Basic Sciences/Biologics; Trauma; Other INTRODUCTION/PURPOSE: Malnutrition is known to be negatively associated with outcomes after multiple orthopedic procedures. We hypothesized that admission albumin levels, as a maker for malnutrition, would correlate with postoperative outcomes. The purpose of this study is to investigate this relationship following surgery for ankle fracture. METHODS: This is a retrospective cohort study of the ACS-NSQIP database. Patients undergoing operative fixation of an ankle fracture were identified. 6,138 patients with albumin available for analysis were identified. Baseline patient information, preoperative serum albumin levels, 30-day postoperative complications, readmission, reoperation, and length of stay data were then collected. Poisson regression with robust error variance was performed to assess the effect of preoperative serum albumin level on postoperative outcomes. RESULTS: 6,138 patients with albumin available for analysis were identified in the database. The mean albumin level was 3.86 g/dl and 20.3% of patients with available albumin levels were hypoalbuminemic. Multivariate analysis revealed that albumin level <3.5 g/dl is an independent risk factor for complication (RR 1.42, 95% CI 1.13-1.78, p=0.002) and readmission (RR 1.54, 95% CI 1.13- 2.08, p =0.006). Additionally, when analyzed as a continuous variable, albumin level was negatively correlated with risk of mortality (RR 0.37, 95% CI 0.19-0.72, p=0.003). Patients with hypoalbuminemia also had significantly longer length of stays (4.5 v. 2.1 days, p<0.001). CONCLUSION: While complication rates after fixation of ankle fractures remain low, hypoalbuminemia is a predictor of postoperative course. Malnutrition, therefore, may help inform the decision between surgical and conservative management of patients with ankle fractures potentially amenable to non-operative management. Additionally, hypoalbuminemia should trigger heightened awareness and prophylactic therapy where appropriate.
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spelling pubmed-87027732022-01-28 Hypoalbuminemia is an Independent Predictor of 30-Day Postoperative Complications Following Surgical Fixation of Ankle Fractures Kukowski, Nathan Wilson, Jacob M. Bariteau, Jason T. Staley, Christopher A. Foot Ankle Orthop Article CATEGORY: Basic Sciences/Biologics; Trauma; Other INTRODUCTION/PURPOSE: Malnutrition is known to be negatively associated with outcomes after multiple orthopedic procedures. We hypothesized that admission albumin levels, as a maker for malnutrition, would correlate with postoperative outcomes. The purpose of this study is to investigate this relationship following surgery for ankle fracture. METHODS: This is a retrospective cohort study of the ACS-NSQIP database. Patients undergoing operative fixation of an ankle fracture were identified. 6,138 patients with albumin available for analysis were identified. Baseline patient information, preoperative serum albumin levels, 30-day postoperative complications, readmission, reoperation, and length of stay data were then collected. Poisson regression with robust error variance was performed to assess the effect of preoperative serum albumin level on postoperative outcomes. RESULTS: 6,138 patients with albumin available for analysis were identified in the database. The mean albumin level was 3.86 g/dl and 20.3% of patients with available albumin levels were hypoalbuminemic. Multivariate analysis revealed that albumin level <3.5 g/dl is an independent risk factor for complication (RR 1.42, 95% CI 1.13-1.78, p=0.002) and readmission (RR 1.54, 95% CI 1.13- 2.08, p =0.006). Additionally, when analyzed as a continuous variable, albumin level was negatively correlated with risk of mortality (RR 0.37, 95% CI 0.19-0.72, p=0.003). Patients with hypoalbuminemia also had significantly longer length of stays (4.5 v. 2.1 days, p<0.001). CONCLUSION: While complication rates after fixation of ankle fractures remain low, hypoalbuminemia is a predictor of postoperative course. Malnutrition, therefore, may help inform the decision between surgical and conservative management of patients with ankle fractures potentially amenable to non-operative management. Additionally, hypoalbuminemia should trigger heightened awareness and prophylactic therapy where appropriate. SAGE Publications 2020-11-06 /pmc/articles/PMC8702773/ http://dx.doi.org/10.1177/2473011420S00307 Text en © The Author(s) 2020 https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Article
Kukowski, Nathan
Wilson, Jacob M.
Bariteau, Jason T.
Staley, Christopher A.
Hypoalbuminemia is an Independent Predictor of 30-Day Postoperative Complications Following Surgical Fixation of Ankle Fractures
title Hypoalbuminemia is an Independent Predictor of 30-Day Postoperative Complications Following Surgical Fixation of Ankle Fractures
title_full Hypoalbuminemia is an Independent Predictor of 30-Day Postoperative Complications Following Surgical Fixation of Ankle Fractures
title_fullStr Hypoalbuminemia is an Independent Predictor of 30-Day Postoperative Complications Following Surgical Fixation of Ankle Fractures
title_full_unstemmed Hypoalbuminemia is an Independent Predictor of 30-Day Postoperative Complications Following Surgical Fixation of Ankle Fractures
title_short Hypoalbuminemia is an Independent Predictor of 30-Day Postoperative Complications Following Surgical Fixation of Ankle Fractures
title_sort hypoalbuminemia is an independent predictor of 30-day postoperative complications following surgical fixation of ankle fractures
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8702773/
http://dx.doi.org/10.1177/2473011420S00307
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