The Effect of Preoperative Nutritional Depletion on Postoperative Complications in the patient with Multiple Injuries / 대한정형외과학회잡지

ABSTRACT

The importance of maintaining appropriate nutrition in the patient with serious multiple injuries may be overlooked by the orthopedic surgeon. Nutritional depletion has a significant effect on survival, wound healing, immunocompetence, fracture healing and rehabilitation of the patient. A prospective study was performed to determine the effect of preoperative nutritional status on the postoperative complications in forty patients who had been admitted to the hospital because of multiple injuries. The parameters that were used to determine the nutritional status included serum levels of albumin, transferrin, and hemoglobin; TCL(total lymphocyte count);and CHI(creatinine height index). The results were as follows 1. Significant preoperative nutritional depletion of moderate or severe degree in at least one of the 5 indices was indentified in 25(62.5%) of the 40 patients. 2. Incidence of preoperative nutritional depletion ranged from 7.5% for hemoglobin to 52.5% for transferrin and the nutritional depletion averged 29.5% abnormality per nutritional index. 3. Twenty complications were observed in 18 patients. 4. The incidence of preoperative nutritional depletion was 83.3% in complication group and 45.5% in non-complication group. 5. Serum albumin level and serum transferrin level had significant predictive value of postoperative complication.