PREOPERATIVE NUTRITIONAL-STATUS AND OUTCOME OF ELECTIVE TOTAL HIP-REPLACEMENT

Preoperative malnutrition increases the morbidity rate and length of h ospitalization for various types of surgical patients, However, among patients who undergo elective total hip replacement, it is unclear how preoperative nutritional data can be used to detect a high risk subgr oup. The purpose of this study was to identify preoperative nutritiona l factors that could be used to define a subgroup of patients who have undergone elective total hip replacement who are at high risk for poo r postoperative outcome, Preoperative nutritional factors were evaluat ed in 89 consecutive patients who underwent elective total hip replace ment. An inverse relationship was found between serum albumin and leng th of stay. Patients with an albumin level less than 3.9 were twice as likely to require prolonged hospitalization (>15 days) when compared with those in whom the albumin level was 3.9 or greater, Complications were related to the preoperative orthopaedic diagnosis of avascular n ecrosis of the hip. A subgroup of the patients undergoing elective tot al hip replacement who are at risk for prolonged recovery can be ident ified preoperatively by using a serum albumin level of less than 3.9 g /dl. The traditional normal range for albumin may be inappropriate for these patients.