Preoperative malnutrition is a risk factor for delayed recovery of mobilization after total hip arthroplasty
Yuta Nanri, Manaka Shibuya, Kensuke Fukushima, Katsufumi Uchiyama, Naonobu Takahira, Masashi Takaso
Abstract
INTRODUCTION: Many studies have examined nutritional status and deteriorated postoperative outcomes in patients undergoing total hip arthroplasty. However, few studies have focused on nutritional status and postoperative mobility. OBJECTIVE: To investigate the impact of preoperative nutritional status on mobility after total hip arthroplasty. DESIGN: Retrospective single-institution cohort study. SETTING: Orthopedic inpatient rehabilitation center. PARTICIPANTS: A total of 503 patients who underwent unilateral primary total hip arthroplasty from 2015 through 2019 were included. METHODS: Data were collected on patient demographics, comorbidities, preoperative nutritional status, and quadriceps strength. Nutritional status was assessed using the Controlling Nutritional Status (CONUT) score. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURE: The primary outcome was postoperative mobility defined as the number of days from surgery to starting to walk independently. RESULTS: Among 503 patients undergoing total hip arthroplasty, 18.9% were classified as malnourished. Patients with malnutrition had a one-day delay in achieving mobilization compared with patients with normal nutrition (6 vs. 5 days, P = .006). According to the Kaplan-Meier curves, patients with malnutrition had a significant delay in mobilization compared with those with normal nutrition (P < .001). All three Cox proportional hazards regression models showed that preoperative malnutrition was associated with a higher risk of delayed mobilization (hazard ratios 0.70-0.74). CONCLUSIONS: Preoperative malnutrition as assessed by the CONUT is a significant risk factor for delayed recovery of mobilization after total hip arthroplasty.