Malnutrition in orthopaedic trauma outcomes (MOTO): orthopedic trauma patients can be effectively screened and stratified for risk of malnutrition using prealbumin. A preliminary outcome study.

Objectives: To evaluate prealbumin (PAB) as a prognostic indicator for early detection of malnutrition risk upon admission and its correlation with in-hospital complications and length of stay (LOS) in patients with orthopedic trauma. Methods: Design: Retrospective cohort. Setting: Urban academic Level 1 trauma center. Patients/Participants: One hundred fifty-eight patients aged 18 years or older with acute traumatic fractures indicated for primary surgical fixation between 2019 and 2022 were included. Serum laboratory tests consisting of PAB, C-reactive protein, complete blood counts, and complete metabolic panel were obtained within 24 hours of arrival. Outcome Measures and Comparisons: Primary outcome measures included characterization of patient risk factors for increased intensive care unit LOS, hospital LOS, and in-hospital complications. Secondary outcome measures included characterization of patients who were stratified as "at risk" for malnutrition by PAB < 20 mg/dL and identification of complication predictors. Results: Fifty-one (32%) patients were stratified as "at risk" for malnutrition based on serum PAB < 20 mg/dL drawn within 24 hours of arrival. These patients had longer median hospital LOS ( Conclusions: Patients with orthopaedic trauma can reliably and cost-effectively be screened and stratified for risk of malnutrition using PAB drawn with immediate admission labs. Level of Evidence: Level III.