1
|
Liao J, Chen J, Xu W, Chen J, Liang X, Cheng Q, Tang Y, Huang W. Prevalence and associations of sarcopenia, obesity and sarcopenic obesity in end-stage knee osteoarthritis patients. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2023; 42:108. [PMID: 37833797 PMCID: PMC10571463 DOI: 10.1186/s41043-023-00438-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Accepted: 08/25/2023] [Indexed: 10/15/2023]
Abstract
OBJECTIVE To identify the prevalence of obesity, sarcopenia, sarcopenic obesity in end-stage knee osteoarthritis (KOA) patients and analyze influences of obesity and sarcopenia in the progression of KOA. METHODS A cross-sectional study was carried out among end-stage KOA patients who consecutively admitted to Orthopedic Department for TKA. We suppose that the level of decreased physical activities would be influenced by unilateral or bilateral KOA. Patient information, albumin, hemoglobin, pace, step frequency, number of comorbid conditions were collected. Bioelectrical impedance analyzer was used to analyze body composition. Obesity, sarcopenia, sarcopenic obesity rate were analyzed with accepted diagnosis criteria. Correlations between body mass index (BMI) or age and fat mass (FM), appendicular skeletal muscle mass (ASM) were analyzed. RESULTS 138 patients (male 30, female 108) in southwest of China including 67 patients with unilateral KOA and 71 patients with bilateral KOA were analyzed. No statistic difference was found in mean albumin, prealbumin and hematocrystallin, body composition values and number of comorbid conditions. We found that BMI was positively correlated with FM (Male: R2 = 0.7177, p < 0.0001, Female: R2 = 0.8898, p < 0.0001), ASM (Male: R2 = 0.2640, p = 0.0037, Female: R2 = 0.2102, p < 0.0001), FM index (FMI) (Male: R2 = 0.6778, p < 0.0001, Female: R2 = 0.8801, p < 0.0001), and ASM index (ASMI) (Male: R2 = 0.3600, p = 0.0005, Female: R2 = 0.4208, p < 0.0001) in end-stage KOA patients. However, age was not obviously correlated with FM or FMI (Male: FM, R2 = 0.006911, p = 0.3924; FMI, R2 = 0.7554, p = 0.0009196; Female: FM, R2 = 0.001548, p = 0.8412; FMI, R2 = 0.002776, p = 0.7822). And slightly negatively correlated with ASM (Male: R2 = 0.05613, p = 0.0136, Female: R2 = 0.01327, p = 0.5433) and ASMI (Male: R2 = 0.02982, p = 0.3615; Female: R2 = 0.03696, p = 0.0462). The prevalence of obesity, sarcopenia and obesity sarcopenia differs according to different diagnosis criteria. No difference in the occurrence rate of obesity was found between bilateral KOA and unilateral KOA patients, and occurrence rates of sarcopenia and sarcopenic obesity were statistically higher in bilateral KOA than that in unilateral KOA patients. CONCLUSIONS Obesity, sarcopenia and sarcopenic obesity are highly prevalent in end-stage KOA patients, sarcopenic obesity are more prevalent in bilateral KOA patients than that in unilateral KOA patients.
Collapse
Affiliation(s)
- Junyi Liao
- Department of Orthopedic Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
- Orthopedic Laboratory of Chongqing Medical University, Chongqing, 400016, China
| | - Jie Chen
- Department of Orthopedic Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Wei Xu
- Department of Orthopedic Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
- Orthopedic Laboratory of Chongqing Medical University, Chongqing, 400016, China
| | - Jia Chen
- Department of Nutriology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Xi Liang
- Department of Orthopedic Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
- Orthopedic Laboratory of Chongqing Medical University, Chongqing, 400016, China
| | - Qiang Cheng
- Department of Orthopedic Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China.
- Orthopedic Laboratory of Chongqing Medical University, Chongqing, 400016, China.
| | - Yongli Tang
- Department of Orthopedic Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China.
- Orthopedic Laboratory of Chongqing Medical University, Chongqing, 400016, China.
| | - Wei Huang
- Department of Orthopedic Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China.
- Orthopedic Laboratory of Chongqing Medical University, Chongqing, 400016, China.
| |
Collapse
|
2
|
Tsutsui T, Fujiwara T, Matsumoto Y, Kimura A, Kanahori M, Arisumi S, Oyamada A, Ohishi M, Ikuta K, Tsuchiya K, Tayama N, Tomari S, Miyahara H, Mae T, Hara T, Saito T, Arizono T, Kaji K, Mawatari T, Fujiwara M, Takasaki M, Shin K, Ninomiya K, Nakaie K, Antoku Y, Iwamoto Y, Nakashima Y. Geriatric nutritional risk index as the prognostic factor in older patients with fragility hip fractures. Osteoporos Int 2023:10.1007/s00198-023-06753-3. [PMID: 37067545 DOI: 10.1007/s00198-023-06753-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 04/06/2023] [Indexed: 04/18/2023]
Abstract
This study investigated the long-term survival and incidence of secondary fractures after fragility hip fractures. The 5-year survival rate was 62%, and the mortality risk was seen in patients with GNRI < 92. The 5-year incidence of secondary fracture was 22%, which was significantly higher in patients with a BMI < 20. BACKGROUND Malnutrition negatively influences the postoperative survival of patients with fragility hip fractures (FHFs); however, little is known about their association over the long term. OBJECTIVE This study evaluated the ability of the geriatric nutritional risk index (GNRI) as a risk factor for long-term mortality after FHFs. METHODS This study included 623 Japanese patients with FHFs over the age of 60 years. We prospectively collected data on admission and during hospitalization and assessed the patients' conditions after discharge through a questionnaire. We examined the long-term mortality and the incidence of secondary FHFs and assessed the prognostic factors. RESULTS The mean observation period was 4.0 years (range 0-7 years). The average age at the time of admission was 82 years (range 60-101 years). The overall survival after FHFs (1 year, 91%; 5 years, 62%) and the incidence of secondary FHFs were high (1 year, 4%; 5 years, 22%). The multivariate Cox proportional hazard analysis revealed the risk factors for mortality as older age (hazard ratio [HR] 1.04), male sex (HR 1.96), lower GNRI score (HR 0.96), comorbidities (malignancy, HR 2.51; ischemic heart disease, HR 2.24; revised Hasegawa dementia scale ≤ 20, HR 1.64), no use of active vitamin D3 on admission (HR 0.46), and a lower Barthel index (BI) (on admission, HR 1.00; at discharge, HR 0.99). The GNRI scores were divided into four risk categories: major risk (GNRI, < 82), moderate risk (82-91), low risk (92-98), and no risk (> 98). Patients at major and moderate risks of GNRI had a significantly lower overall survival rate (p < 0.001). Lower body mass index (BMI) was also identified as a prognostic factor for secondary FHFs (HR 0.88 [p = 0.004]). CONCLUSIONS We showed that older age, male sex, a lower GNRI score, comorbidities, and a lower BI are risk factors for mortality following FHFs. GNRI is a novel and simple predictor of long-term survival after FHFs.
Collapse
Affiliation(s)
- T Tsutsui
- Department of Orthopaedic Surgery, Graduate School of Medical Science, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - T Fujiwara
- Department of Orthopaedic Surgery, Graduate School of Medical Science, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
| | - Y Matsumoto
- Department of Orthopaedic Surgery, Graduate School of Medical Science, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - A Kimura
- Department of Orthopaedic Surgery, Graduate School of Medical Science, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - M Kanahori
- Department of Orthopaedic Surgery, Graduate School of Medical Science, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - S Arisumi
- Department of Orthopaedic Surgery, Graduate School of Medical Science, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - A Oyamada
- Department of Orthopaedic Surgery, Saga Handicapped Children's Hospital, Saga, Japan
| | - M Ohishi
- Department of Orthopaedic Surgery, Chihaya Hospital, Fukuoka, Japan
| | - K Ikuta
- Department of Orthopaedic Surgery, Karatsu Red Cross Hospital, Saga, Japan
| | - K Tsuchiya
- Department of Orthopaedic Surgery, Japan Community Healthcare Organization, Kyushu Hospital, Fukuoka, Japan
| | - N Tayama
- Department of Orthopaedic Surgery, Steel Memorial Yawata Hospital, Fukuoka, Japan
| | - S Tomari
- Department of Orthopaedic Surgery, Japanese Red Cross Fukuoka Hospital, Fukuoka, Japan
| | - H Miyahara
- Department of Orthopaedic Surgery, National Hospital Organization Kyushu Medical Centre, Fukuoka, Japan
| | - T Mae
- Department of Orthopaedic Surgery, Saga-Ken Medical Centre Koseikan, Saga, Japan
| | - T Hara
- Department of Orthopaedic Surgery, Aso Iizuka Hospital, Fukuoka, Japan
| | - T Saito
- Department of Orthopaedic Surgery, Fukuoka City Hospital, Fukuoka, Japan
| | - T Arizono
- Department of Orthopaedic Surgery, Kyushu Central Hospital of the Mutual Aid Association of Public School Teachers, Fukuoka, Japan
| | - K Kaji
- Department of Orthopaedic Surgery, Kyushu Rosai Hospital, Fukuoka, Japan
| | - T Mawatari
- Department of Orthopaedic Surgery, Hamanomachi Hospital, Fukuoka, Japan
| | - M Fujiwara
- Department of Orthopaedic Surgery, Sada Hospital, Fukuoka, Japan
| | - M Takasaki
- Department of Orthopaedic Surgery, Harasanshin Hospital, Fukuoka, Japan
| | - K Shin
- Department of Orthopaedic Surgery, Saiseikai Yahata General Hospital, Fukuoka, Japan
| | - K Ninomiya
- Department of Orthopaedic Surgery, Koga Hospital 21, Fukuoka, Japan
| | - K Nakaie
- Department of Orthopaedic Surgery, National Hospital Organization Fukuoka-Higashi Medical Centre, Fukuoka, Japan
| | - Y Antoku
- Faculty of Medicine, Hospital Informatic Centre, Oita University, Oita, Japan
| | - Y Iwamoto
- Department of Orthopaedic Surgery, Kyushu Rosai Hospital, Fukuoka, Japan
| | - Y Nakashima
- Department of Orthopaedic Surgery, Graduate School of Medical Science, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| |
Collapse
|
3
|
Liu H, Zhang F, Li Y. Application evaluation of multidisciplinary collaboration model with health care integration in perioperative period of femoral neck fracture. Biotechnol Genet Eng Rev 2023:1-11. [PMID: 36651912 DOI: 10.1080/02648725.2023.2167421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 01/06/2023] [Indexed: 01/19/2023]
Abstract
This study was to analyze application effect of multidisciplinary collaboration model with health-care integration in perioperative period of femoral neck fracture. As a prospective study, 124 patients with femoral neck fracture who underwent artificial joint replacement in our hospital from August 2020 to August 2021 were selected as the study subjects. According to the random allocation, they were divided into the group A (n = 62, multidisciplinary collaboration model with health-care integration) and the group B (n = 62, conventional care) to analyze the clinical value of different intervention measures in perioperative period by comparing the hip joint activity, quality of life and incidence of perioperative complications between the two groups. Compared with group B, the average HHS score and hip joint activity after intervention in group A were notably higher (P < 0.05), the VAS score after intervention was overtly lower (P < 0.001), and the GQOLI-74 score of group A after intervention was visibly higher (P < 0.001), with no overt difference in the overall incidence of perioperative complications between the two groups (P > 0.05). The application of multidisciplinary collaboration model with health-care integration in femoral neck fracture can effectively improve the hip joint function, reduce the severity of pain and benefit patients, and further studies will help to establish a better solution for such patients.
Collapse
Affiliation(s)
- Hongyu Liu
- Department of Joint surgery, Jinan Fourth People's Hospital, Jinan, Shandong, China
| | - Fuling Zhang
- Department of Spine Surgery, Jinan Fourth People's Hospital, Jinan, Shandong, China
| | - Yuanyuan Li
- Department of Spine Surgery, Jinan Fourth People's Hospital, Jinan, Shandong, China
| |
Collapse
|
5
|
Are Routine Postoperative Laboratory Tests Necessary After Primary Total Hip Arthroplasty? J Arthroplasty 2020; 35:2892-2898. [PMID: 32466996 DOI: 10.1016/j.arth.2020.04.097] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Revised: 04/26/2020] [Accepted: 04/29/2020] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Recently, the practice of ordering routine postoperative laboratory tests in primary total hip arthroplasty (THA) has been challenged. This study aimed to evaluate the utility of routine postoperative laboratory tests after primary elective THA in an Asian population and identify the risk factors associated with abnormal postoperative laboratory test-related intervention. METHODS We retrospectively reviewed 395 consecutive patients who underwent primary elective THA at a single tertiary academic center. Patient clinical information and laboratory test results were collected for analysis. RESULTS A total of 349 (88.4%) patients had abnormal postoperative laboratory test results; most patients had anemia and hypoalbuminemia. Twenty-seven (6.8%) patients received clinical intervention. Of the 307 (77.7%) patients with postoperative anemia, 7 patients received blood transfusion. Factors associated with transfusion were female gender, low body mass index, long operation time, and low preoperative hemoglobin levels. Of the 149 (37.7%) patients with postoperative hypoalbuminemia, 16 received albumin supplementation. Factors associated with albumin supplementation were female gender, long operation time, and low preoperative albumin levels. Although 36 patients had abnormal postoperative creatinine, only 1 patient required specialist consultation. For electrolyte abnormalities, hyponatremia was noted; however, no patient received sodium supplementation. Moreover, 14 patients developed hypokalemia, of which 6 required potassium supplementation; 163 patients had hypocalcemia, of which 2 received calcium supplementation. CONCLUSION Routine laboratory tests after primary elective THA are unnecessary for most of the patients in modern clinical practice. However, for those with identified risk factors, postoperative laboratory tests still should be performed.
Collapse
|