The Impact of Malnutrition on 30-Day Postoperative Complications following Surgical Fixation of Distal Radius Fractures

Jared M. Newman; Marine Coste; Karan Dua; Andrew Yang; Frank S. Cautela; Neil V. Shah; Aakash M. Patel; Alexander Chee; Anton Khlopas; Steven M. Koehler

doi:10.1055/s-0039-3400433

Journal of Hand and Microsurgery, Table of Contents

J Hand Microsurg 2020; 12(S 01): S33-S38
DOI: 10.1055/s-0039-3400433

Original Article

The Impact of Malnutrition on 30-Day Postoperative Complications following Surgical Fixation of Distal Radius Fractures

Authors

Jared M. Newman

¹Department of Orthopaedic Surgery and Rehabilitation Medicine, SUNY Downstate Medical Center, Brooklyn, New York, United States
Marine Coste

¹Department of Orthopaedic Surgery and Rehabilitation Medicine, SUNY Downstate Medical Center, Brooklyn, New York, United States
Karan Dua

¹Department of Orthopaedic Surgery and Rehabilitation Medicine, SUNY Downstate Medical Center, Brooklyn, New York, United States
Andrew Yang

¹Department of Orthopaedic Surgery and Rehabilitation Medicine, SUNY Downstate Medical Center, Brooklyn, New York, United States
Frank S. Cautela

¹Department of Orthopaedic Surgery and Rehabilitation Medicine, SUNY Downstate Medical Center, Brooklyn, New York, United States
Neil V. Shah

¹Department of Orthopaedic Surgery and Rehabilitation Medicine, SUNY Downstate Medical Center, Brooklyn, New York, United States
Aakash M. Patel

²Department of Orthopaedic Surgery, Chicago College of Osteopathic Medicine, Midwestern University, Downers Grove, Illinois, United States
Alexander Chee

¹Department of Orthopaedic Surgery and Rehabilitation Medicine, SUNY Downstate Medical Center, Brooklyn, New York, United States
Anton Khlopas

³Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, Ohio, United States
Steven M. Koehler

¹Department of Orthopaedic Surgery and Rehabilitation Medicine, SUNY Downstate Medical Center, Brooklyn, New York, United States

Abstract

Introduction Distal radius fractures (DRFs) are increasingly managed surgically among fragility fractures due to prolonged life expectancy and surgical advancements. Yet, malnutrition can impact postoperative outcomes and complications. We sought to determine the impact of malnutrition on open reduction and internal fixation (ORIF) of DRFs during the perioperative and 30-day postoperative periods.

Materials and Methods Using the National Surgical Quality Improvement Program database, all patients who underwent ORIF of a DRF between January 1, 2008, and December 31, 2016, were identified and stratified by preoperative serum albumin levels: normal (≥3.5 g/dL; n = 2,546) or hypoalbuminemia (<3.5 g/dL; n = 439). Demographical and perioperative data were compared. Operative complications were stratified into major and minor complications, and data were analyzed using descriptive statistics and multivariate regression models.

Results Compared with patients with normal levels, a higher proportion of hypoalbuminemia patients had ASA scores > 3 (9.1 vs. 2%) and a longer mean length of stay (3.16 vs. 0.83 days). Hypoalbuminemia patients also had 625% greater odds for developing major complications during the 30-day postoperative period (odds ratio = 7.25; 95% confidence interval: 1.91–27.49).

Conclusion Malnutrition significantly affected outcomes and complications of distal radius ORIF. This study highlights the importance of prevention and treatment of malnutrition in the setting of fragility fractures.

Keywords

distal radius fracture - fragility - hypoalbuminemia - malnutrition - open reduction internal fixation - complications - surgical fixation

Full Text

References

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