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Perioperative nutritional status thought to be important, but poorly understood

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European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Objectives

Malnutrition has been shown to increase complications and leads to poor outcomes in surgical patients, but it has not been studied extensively in orthopedic trauma. This study’s purpose is to determine the perspective and assessment of nutrition by orthopedic traumatologists.

Methods

A survey was created and distributed via REDCap to orthopedic traumatologists at 60 U.S. trauma centers. Out of 183 distributed surveys, 130 surgeons completed the survey (71%). The survey focused on the importance of nutrition and practice patterns in orthopedic trauma.

Results

Seventy-five percent of surgeons thought that nutritional status was “very important” to the final outcome of patients with orthopedic trauma injuries, 24% responded “somewhat important” and 1% responded “not important.” Furthermore, 88% perform nutritional assessments; most surgeons (77%) utilize nutritional laboratory markers, with the most common markers being albumin, pre-albumin, transferrin and CRP. Additionally, 42% think trending the laboratory markers is important, and 50% are not sure if nutrition markers should be tested at multiple time points. Despite 75% of surgeons believing that nutrition is very important, only 8% discuss it with patients routinely. When asked what is more important for outcomes, nutrition or Vitamin D, almost three times as many surgeons thought nutrition was more important (29% vs 11%, respectively).

Conclusions

While orthopedic traumatologists believe nutrition is an important determinant of patient outcomes, this study shows a clear lack of consensus and variability in practice regarding nutrition among surgeons. Orthopedic trauma surgeons need specific guidelines on how to assess and treat malnutrition in trauma patients.

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Acknowledgements

The authors would like to thank Rebecca Pickard, MA (METRC CC JHSPH) for editing, and Elias Weston-Farber for figure design.

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Authors and Affiliations

  1. University of Washington Harborview Medical Center, 325 9th Ave, Seattle, WA, 98104, USA

    Reza Firoozabadi & Navin Fernando

  2. Major Extremity Trauma and Rehabilitation Consortium Coordinating Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA

    Tara J. Taylor & Renan C. Castillo

  3. Atrium Health Carolinas Medical Center, Charlotte, USA

    Joseph R. Hsu

  4. Vanderbilt University Medical Center, Nashville, USA

    Daniel Stinner & William Obremskey

Authors
  1. Reza Firoozabadi
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  2. Tara J. Taylor
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  3. Navin Fernando
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  7. Renan C. Castillo
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for the Major Extremity Trauma Research Consortium (METRC)

Corresponding author

Correspondence to Reza Firoozabadi.

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Conflict of interest

This work was supported by the Department of Defense, through the Peer Reviewed orthopedic Research Program under award number W81XWH-09-2-0108. The DOD’s Human Research Protection Office reviewed and approved this study. The authors have no competing interests to declare that are relevant to the content of this article.

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Firoozabadi, R., Taylor, T.J., Fernando, N. et al. Perioperative nutritional status thought to be important, but poorly understood. Eur J Orthop Surg Traumatol 34, 1845–1850 (2024). https://doi.org/10.1007/s00590-024-03858-1

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  • DOI: https://doi.org/10.1007/s00590-024-03858-1

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