ArticleJournal of orthopaedic surgery and research2023
Concomitant malnutrition and frailty are significant risk factors for poor outcome following two-stage revision for chronic periprosthetic joint infection.
Article in Journal of orthopaedic surgery and research, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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8 citing papers in PubMed, 5 citations in OpenAlex.
- Predicting 5-Year Mortality After Prosthetic Joint Infection Using a 30-Item Accumulated Frailty Index in a 13,371-Patient Multicenter Cohort.Arthroplasty today · 2026Article
- Can frailty predict complications and mortality in patients undergoing total knee arthroplasty? A systematic review and meta-analysis.Pakistan journal of medical sciences · 2026Article
- The Prognostic Value of Frailty Assessment Tools in Predicting Postoperative Outcomes After Revision Total Hip and Knee Arthroplasty: A Systematic Review.Journal of clinical medicine · 2026Review
- Malnutrition drives re-revision and mortality in elderly revision arthroplasty: the prognostic value of GNRI.BMC musculoskeletal disorders · 2026Article
- Preoperative malnutrition and risk of re-revision and mortality following revision arthroplasty.International journal of surgery (London, England) · 2026Article
- Nutritional status and postoperative recovery outcomes in patients undergoing orthopedic surgery.Frontiers in nutrition · 2026Article
- The presence of a sinus tract is associated with reinfection after two-stage revision surgery for prosthetic hip joint infection: a case-control study.BMC musculoskeletal disorders · 2024Article
- Preoperative Risk Factors for Periprosthetic Joint Infection: A Narrative Review of the Literature.Healthcare (Basel, Switzerland) · 2024Review
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6 authors at 3 institutions in 1 country.
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Abstract
backgroundTwo-stage revision remains the gold standard for periprosthetic joint infection (PJI) treatment. Although previous studies have examined malnutrition and frailty independently, their cumulative effects are not clear. Therefore, this study aimed to assess the individual and combined influence of malnutrition and frailty on the two-stage revision surgery.
methodsPatients with chronic PJI undergoing two-stage revision were retrospectively included. The definition of PJI is completely consistent with the evidence-based definition of PJI recorded by the MSIS in 2018. Preoperative serum albumin levels and 11-item modified frailty index scores were collected. Four cohorts were created: (1) Normal (N), (2) Frail (F), (3) Malnourished (M), and (4) Malnourished and frail (MF). Demographic data, comorbidities, and postoperative complications were collected and compared between the four cohorts.
resultsA total of 117 consecutive patients were enrolled, 48% of patients were healthy (27.4% F, 16.2% M, and 9.4% MF). MF group showed lower scores on the physical composite scale of the 12-item short-form health survey (SF12-PCS), mental composite summary (SF12-MCS), Harris hip score (HHS), and knee society score (KSS) (P < 0.05). The incidence of reinfection in the MF group was higher than that in all other groups (MF vs. N; odds ratio [OR] 3.7, 95% confidence interval [CI] 1.37 - 8.82, P = 0.032). The incidence of complications in the MF group was higher than that in all other groups (MF vs. N; OR 4.81, 95% CI 1.58-9.26, P = 0.018). Postoperative transfusion events (OR 2.92, 95% CI 1.27-3.09, P = 0.021), readmission at 60 days after the operation (OR 4.91, 95% CI 1.82-13.80, P = 0.012) was higher in the MF patients. In addition, the extended length of stay after the operation was highest in the MF patients, with an OR of 5.78 (95% CI 2.16-12.04, P = 0.003).
conclusionThe concurrent presence of concomitant malnutrition and frailty in patients with PJI is related to poor prognosis and may be a predictor of the efficacy of two-stage revision. Future research will be needed to describe the benefits of improving these risk factors for patients with PJI.
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