Shoulder arthroscopy in elderly patients: malnutrition and early postoperative outcomes
Background: This study investigates the association between the Geriatric Nutritional Risk Index (GNRI), a simple, readily available malnutrition risk index, and 30-day postoperative complications following shoulder arthroscopy. Methods: The American College of Surgeons National Surgical Quality Imp...
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| Format: | Article |
| Language: | English |
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Elsevier
2024-01-01
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| Series: | JSES International |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666638323002359 |
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| author | Steven H. Liu, BS Patricia Cerri-Droz, BS Rachel A. Loyst, BS David E. Komatsu, PhD Edward D. Wang, MD |
| author_facet | Steven H. Liu, BS Patricia Cerri-Droz, BS Rachel A. Loyst, BS David E. Komatsu, PhD Edward D. Wang, MD |
| author_sort | Steven H. Liu, BS |
| collection | DOAJ |
| description | Background: This study investigates the association between the Geriatric Nutritional Risk Index (GNRI), a simple, readily available malnutrition risk index, and 30-day postoperative complications following shoulder arthroscopy. Methods: The American College of Surgeons National Surgical Quality Improvement Program database was used to identify all patients aged ≥65 years who underwent shoulder arthroscopy between 2015 and 2021. The study population was indexed into 3 cohorts of preoperative GNRI: normal/reference (GNRI >98), moderate malnutrition (92≤ GNRI ≤98), and severe malnutrition (GNRI <92). Multivariate logistic regression analysis was conducted to investigate the connection between preoperative GNRI and postoperative complications. Results: Severe malnutrition was independently significantly associated with a greater likelihood of any complication (odds ratio [OR]: 11.70, 95% confidence interval [CI]: 8.58-15.94; P < .001), sepsis (OR: 26.61, 95% CI: 10.86-65.21; P < .001), septic shock (OR: 7.53, 95% CI: 1.56-36.32; P = .012), blood transfusions (OR: 25.38, 95% CI: 6.40-100.59; P < .001), pulmonary embolism (OR: 7.25, 95% CI: 1.27-41.40; P = .026), surgical site infection (OR: 22.08, 95% CI: 7.51-64.97; P < .001), nonhome discharge (OR: 15.75, 95% CI: 9.83-25.23; P < .001), readmission (OR: 2.69, 95% CI: 1.52-4.74; P < .001), unplanned reoperation (OR: 6.32, 95% CI: 2.23-17.92; P < .001), length of stay >2 days (OR: 23.66, 95% CI: 16.25-34.45; P < .001), and mortality (OR: 14.25, 95% CI: 2.89-70.40; P = .001). Conclusion: GNRI-based malnutrition is strongly predictive of perioperative complications following shoulder arthroscopy in geriatric patients and has utility as an adjunctive risk stratification tool. |
| first_indexed | 2024-03-08T11:24:52Z |
| format | Article |
| id | doaj.art-94119440adf642b7a9fafb3607b94e15 |
| institution | Directory Open Access Journal |
| issn | 2666-6383 |
| language | English |
| last_indexed | 2024-03-08T11:24:52Z |
| publishDate | 2024-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | JSES International |
| spelling | doaj.art-94119440adf642b7a9fafb3607b94e152024-01-26T05:35:21ZengElsevierJSES International2666-63832024-01-01814146Shoulder arthroscopy in elderly patients: malnutrition and early postoperative outcomesSteven H. Liu, BS0Patricia Cerri-Droz, BS1Rachel A. Loyst, BS2David E. Komatsu, PhD3Edward D. Wang, MD4Renaissance School of Medicine, Stony Brook University, Stony Brook, NY, USARenaissance School of Medicine, Stony Brook University, Stony Brook, NY, USARenaissance School of Medicine, Stony Brook University, Stony Brook, NY, USADepartment of Orthopaedics, Stony Brook University, Stony Brook, NY, USADepartment of Orthopaedics, Stony Brook University, Stony Brook, NY, USA; Corresponding author: Edward D. Wang, MD, Department of Orthopaedics, Stony Brook University Hospital, HSC T-18, Room 080, Stony Brook, NY 11794-8181, USA.Background: This study investigates the association between the Geriatric Nutritional Risk Index (GNRI), a simple, readily available malnutrition risk index, and 30-day postoperative complications following shoulder arthroscopy. Methods: The American College of Surgeons National Surgical Quality Improvement Program database was used to identify all patients aged ≥65 years who underwent shoulder arthroscopy between 2015 and 2021. The study population was indexed into 3 cohorts of preoperative GNRI: normal/reference (GNRI >98), moderate malnutrition (92≤ GNRI ≤98), and severe malnutrition (GNRI <92). Multivariate logistic regression analysis was conducted to investigate the connection between preoperative GNRI and postoperative complications. Results: Severe malnutrition was independently significantly associated with a greater likelihood of any complication (odds ratio [OR]: 11.70, 95% confidence interval [CI]: 8.58-15.94; P < .001), sepsis (OR: 26.61, 95% CI: 10.86-65.21; P < .001), septic shock (OR: 7.53, 95% CI: 1.56-36.32; P = .012), blood transfusions (OR: 25.38, 95% CI: 6.40-100.59; P < .001), pulmonary embolism (OR: 7.25, 95% CI: 1.27-41.40; P = .026), surgical site infection (OR: 22.08, 95% CI: 7.51-64.97; P < .001), nonhome discharge (OR: 15.75, 95% CI: 9.83-25.23; P < .001), readmission (OR: 2.69, 95% CI: 1.52-4.74; P < .001), unplanned reoperation (OR: 6.32, 95% CI: 2.23-17.92; P < .001), length of stay >2 days (OR: 23.66, 95% CI: 16.25-34.45; P < .001), and mortality (OR: 14.25, 95% CI: 2.89-70.40; P = .001). Conclusion: GNRI-based malnutrition is strongly predictive of perioperative complications following shoulder arthroscopy in geriatric patients and has utility as an adjunctive risk stratification tool.http://www.sciencedirect.com/science/article/pii/S2666638323002359ShoulderArthroscopyMalnutritionGeriatricGeriatric nutritional risk indexComplications |
| spellingShingle | Steven H. Liu, BS Patricia Cerri-Droz, BS Rachel A. Loyst, BS David E. Komatsu, PhD Edward D. Wang, MD Shoulder arthroscopy in elderly patients: malnutrition and early postoperative outcomes JSES International Shoulder Arthroscopy Malnutrition Geriatric Geriatric nutritional risk index Complications |
| title | Shoulder arthroscopy in elderly patients: malnutrition and early postoperative outcomes |
| title_full | Shoulder arthroscopy in elderly patients: malnutrition and early postoperative outcomes |
| title_fullStr | Shoulder arthroscopy in elderly patients: malnutrition and early postoperative outcomes |
| title_full_unstemmed | Shoulder arthroscopy in elderly patients: malnutrition and early postoperative outcomes |
| title_short | Shoulder arthroscopy in elderly patients: malnutrition and early postoperative outcomes |
| title_sort | shoulder arthroscopy in elderly patients malnutrition and early postoperative outcomes |
| topic | Shoulder Arthroscopy Malnutrition Geriatric Geriatric nutritional risk index Complications |
| url | http://www.sciencedirect.com/science/article/pii/S2666638323002359 |
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