title: Malnutrition in Joint Arthroplasty: Prospective Study Indicates Risk of Unplanned ICU Admission.
abstract: BACKGROUND
  Malnutrition has been linked to poor outcomes after elective joint arthroplasty, but the risk of unplanned postoperative intensive care unit (ICU) admission in malnourished arthroplasty patients is unknown.
  
  
  METHODS
  1098 patients were followed as part of a prospective risk stratification program at a tertiary, high-volume arthroplasty center. Chronic malnutrition was defined as preoperative albumin <3.5 g/dL.
  
  
  RESULTS
  The overall incidence of malnutrition was 16.9% (primary and revision arthroplasty patients). Average BMI was highest for patients in albumin category 3.0-3.5 (BMI 35.7). Preoperative albumin <3.0 and <3.5 g/dL translated to 15.4% and 3.8% rates of unplanned ICU admission, respectively, indicating nutritional status to be a factor in postoperative ICU admission.
  
  
  CONCLUSIONS
  Patients with poor nutritional status must be counseled on the risks of adverse medical complications.
authors.affiliation: Department of Orthopaedic Surgery, Pennsylvania Hospital, Philadelphia PA, USA.
authors.forename: Atul F
authors.initials: AF
authors.lastname: Kamath
authors.affiliation: Department of Orthopaedic Surgery, Pennsylvania Hospital, Philadelphia PA, USA.
authors.forename: Caitlin L
authors.initials: CL
authors.lastname: McAuliffe
authors.affiliation: Department of Orthopaedic Surgery, Pennsylvania Hospital, Philadelphia PA, USA.
authors.forename: Laura M
authors.initials: LM
authors.lastname: Kosseim
authors.affiliation: Department of Orthopaedic Surgery, Pennsylvania Hospital, Philadelphia PA, USA.
authors.forename: Finnah
authors.initials: F
authors.lastname: Pio
authors.affiliation: Department of Orthopaedic Surgery, Pennsylvania Hospital, Philadelphia PA, USA.
authors.forename: Eric
authors.initials: E
authors.lastname: Hume
keywords: Albumin; Intensive Care Unit; Malnutrition; Risk Reduction; Total Joint Arthroplasty (replacement)