title: Preoperative nutritional status of the surgical patients in Jeju.
abstract: BACKGROUND
  To assess the preoperative nutritional status of patients with various disorders and to provide data for pre- and postoperative patient management plans, particularly in the elderly. There is no published information on age-matched and disease-matched preoperative nutritional/immunologic status for orthopedic patients, especially in the elderly, in Jeju.
  
  
  METHODS
  In total, 331 patients with four categories of orthopedic conditions were assessed: 92 elective surgery patients, 59 arthroplasty patients, 145 patients with fractures, and 35 infection patients. Malnutrition was defined as body mass index (BMI) below 18 kg/m(2) of expected body weight (below 20% of normal), serum albumin/globulin ratio below 1.5 (normal range, 1.5 to 2.3), albumin level below 3.5 g/dL, total lymphocyte count below 1,500 cells/mm(3), and lymphocyte/monocyte ratio below 5 versus 1.
  
  
  RESULTS
  In 92 elective surgery patients, the average BMI was 23 kg/m(2), hemoglobin was 15 g/dL, lymphocytes (2,486 cells)/monocytes (465 cells) ratio was 6.1, and the albumin (4.4 g/dL)/globulin (2.5 g/dL) ratio as a protein quotient was 1.7. Among the 59 hip and knee arthroplasty patients, the average BMI was 25 kg/m(2), hemoglobin was 12 g/dL, lymphocytes (2,038 cells)/monocytes (391 cells) ratio was 6.6, and albumin (4.1 g/dL)/globulin (2.4 g/dL) ratio was 1.6. No subject showed malnutrition. Among the 145 fracture patients, the average BMI was 23 kg/m(2). The hemoglobin level was 13 g/dL, monocytes (495 cells)/lymphocytes (1,905 cells) ratio was 1 versus 4.6, and albumin (4.1 d/gL)/globulin (2.5 d/gL) ratio was 1.6. However, both ratios decreased after 70 years of age. Among the 17 of 35 infection patients, albumin levels were below 3.5 g/dL, the average BMI was 22 kg/m(2), lymphocytes (1,532 cells)/monocytes (545 cells) ratio was 2.4 versus 1, and albumin (3.0 g/dL)/globulin (3.3 g/dL) ratio was 0.9, while in 18 patients albumin levels were over 3.5 g/dL, the average BMI was 22 kg/m(2), hemoglobin was 12 g/dL, lymphocytes (1,998 cells)/monocytes (583 cells) ratio was 3 versus 1, and albumin/globulin ratio was 1.4. Thus, in the infection group, approximately 50% of the patients showed poor nutrition and immunosuppression.
  
  
  CONCLUSIONS
  It was found that nutritional and immune condition deteriorated gradually to some degree in elderly patients over 60 years of age.
authors.affiliation: Department of Orthopedic Surgery and Traumatology, Cheju Halla General Hospital, Jeju, Korea.
authors.forename: Myung-Sang
authors.initials: MS
authors.lastname: Moon
authors.affiliation: Department of Orthopedic Surgery and Traumatology, Cheju Halla General Hospital, Jeju, Korea.
authors.forename: Sung-Soo
authors.initials: SS
authors.lastname: Kim
authors.affiliation: Department of Orthopedic Surgery and Traumatology, Cheju Halla General Hospital, Jeju, Korea.
authors.forename: Sang-Yup
authors.initials: SY
authors.lastname: Lee
authors.affiliation: Department of Orthopedic Surgery and Traumatology, Cheju Halla General Hospital, Jeju, Korea.
authors.forename: Dal-Jae
authors.initials: DJ
authors.lastname: Jeon
authors.affiliation: Department of Orthopedic Surgery and Traumatology, Cheju Halla General Hospital, Jeju, Korea.
authors.forename: Min-Geun
authors.initials: MG
authors.lastname: Yoon
authors.affiliation: Moon-Kim's Institute of Orthopedic Research, Seoul, Korea.
authors.forename: Sung-Sim
authors.initials: SS
authors.lastname: Kim
authors.affiliation: CUREnCARE Research, Seoul, Korea.
authors.forename: Hanlim
authors.initials: H
authors.lastname: Moon
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D049628:Body Size; D002648:Child; D006801:Humans; D044342:Malnutrition / Q000097:blood / Q000150:complications / Q000175:diagnosis*; D008875:Middle Aged; D009140:Musculoskeletal Diseases / Q000150:complications / Q000601:surgery*; D009752:Nutritional Status; D057234:Preoperative Period; D056910:Republic of Korea; D055815:Young Adult
keywords: Age; Nutrition; Preoperative; Surgical conditions