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CC BY-NC-ND 4.0 · Avicenna J Med 2015; 05(04): 117-122
DOI: 10.4103/2231-0770.165122
ORIGINAL ARTICLE

Nutritional status as a predictive marker for surgical site infection in total joint arthroplasty

Randa Alfargieny
Department of Orthopedic Surgery, Benghazi Medical Center, Libyan International Medical University, Benghazi, Libya
,
Zuhir Bodalal
Department of Medicine, Faculty of Medicine, Libyan International Medical University, Benghazi, Libya
,
Riyad Bendardaf
Department of Oncology, University Hospital Sharjah, Sharjah, UAE
,
Mustafa El-Fadli
Department of Orthopedic Surgery, Benghazi Medical Center, Libyan International Medical University, Benghazi, Libya
,
Salem Langhi
Department of Orthopedic Surgery, Benghazi Medical Center, Libyan International Medical University, Benghazi, Libya
› Author Affiliations Financial support and sponsorship Nil.
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Abstract

Background: Surgical site infection (SSI) is considered one of the most serious complications in total joint arthroplasty (TJA). This study seeks to analyze the predictive value of preoperative and postoperative nutritional biomarkers for SSI in elective TJA. Methodology: Nutritional markers were gathered retrospectively utilizing patient's records from the orthopedics department at Benghazi Medical Center (BMC). The sample spanned cases admitted during the 20-month period between January 2012 and August 2013 and had undergone either elective total hip replacement or total knee replacement. The collected lab results included a complete blood count, total lymphocyte count (TLC), and serum albumin (S. alb.) levels. The patients were then divided into two groups based on the occurrence of an SSI. Results: A total of 135 total knee (81.5%, n = 110/135) and total hip (18.5%, n = 25/135) replacements were performed at BMC during the study period. Among these cases, 57% (n = 78/135) had patient records suitable for statistical analysis. The average preoperative TLC was 2.422 ×103 cells/mm3 (range = 0.8–4.7 ×103 cells/mm3) whereas that number dropped after the surgery to 1.694 ×103 cells/mm3 (range = 0.6–3.8 ×103 cells/mm3). S. alb. levels showed a mean of 3.973 g/dl (range = 2.9–4.7 g/dl) preoperatively and 3.145 g/dl (range = 1.0–4.1 g/dl) postoperatively. The majority of TJA patients did not suffer any complication (67.4%, n = 91/135) while eight cases (5.9%) suffered from a superficial SSI. Conclusion: Preoperative S. alb. was identified as the only significant predictor for SSI (P = 0.011). Being a preventable cause of postoperative morbidity, it is recommended that the nutritional status (especially preoperative S. alb.) of TJA patients be used as a screening agent and appropriate measures be taken to avoid SSI.

Keywords

Libya - nutrition - serum albumin - surgical site infection - total joint arthroplasty - total lymphocyte count


Publication History

Article published online:
09 August 2021

© 2015. Syrian American Medical Society. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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