|Albumin (mg/dL)||21 days||3.5-5.0||2.8-3.5||2.1-2.7||<2.1|
|Transferrin (mg/dL)||8-9 days||200-400||150-200||100-150||<100|
|Prealbumin (mg/dL)||2 days||16-30||10-15||5-10||<5|
|Total Lymphcyte count||<1,500/mm3|
BMI <18; BMI is calculated using the equation Wt (kg)/ht (m2).
- transferrin levels less than 200 mg/dL, albumin less than 3.5 g/dL, or a total lymphocyte count less than 1500 cells/mm3.
- Patients that are malnourished have a 5-7x higher risk of major wound complications.
- Obese patients are also commonly defienct in Vitamin D (92.9%) and iron (36.2% to 56.9%).
- Mordidly obese (BMI) and IDDM patients are at high risk of being malnourished @10% (Schneider AM, JAAOS2021;29:673-680)
- Dietary protein has been the primary modifiable intervention. Nutition intervention with high protein, antiinflammatory diet has demonstrated shoterf hospital stay, lower initial and readmission costs and lower 90-day total charges. (Schroer WC, Bone oint J 2019;101-B(7-supple-C):17-21)
- Vitamin A, C, and D, zinc, and copper supplementation has also been associated with improved outcomes.
- <3.5 g/dL associated with poor surgical outcome, unfavorable prognosis, increased cost
<2.5 g/dL associated with increased rates of morbidity and mortality.
- Wagner ER, Kamath AF, Fruth KM, Harmsen WS, Berry DJ. Effect of Body Mass Index on Complications and Reoperations After Total Hip Arthroplasty. JBJS 2016.
- Cross MB, Yi PH, Thomas CF, Garcia J, Della Valle, CJ. Evaluation of Malnutrition in Orthopaedic Surgery. J Am Acad Orthop Surg 2014.
- Huang R, Greenky M, Kerr GJ, Austin MS, Parvizi J. The Effect of Malnutrition on Patients Undergoing Elective Joint Arthroplasty. J of Arthroplasty 2013.