P1060 - INFLUENCE OF PREOPERATIVE NUTRITION DISORDERS ON EARLY RECOVERY OUTCOMES AFTER HIP ARTHROPLASTY: A COHORT STUDY OF OLDER ADULTS.

P1060

INFLUENCE OF PREOPERATIVE NUTRITION DISORDERS ON EARLY RECOVERY OUTCOMES AFTER HIP ARTHROPLASTY: A COHORT STUDY OF OLDER ADULTS.

M. Briguglio^1,*, M. Latella¹, P. Sirtori¹, L. Mangiavini^1,2, T. W. Wainwright^3,4,5, G. M. Peretti^1,2, G. Banfi^1,6

¹IRCCS Ospedale Galeazzi - Sant'Ambrogio, ²University “La Statale”, Milan, Italy, ³Bournemouth University, ⁴University Hospitals Dorset, Bournemouth, United Kingdom, ⁵Lanzhou University, Gansu Province, China, ⁶Vita-Salute San Raffaele University, Milan, Italy

Rationale: Diagnostic algorithms of nutrition disorders are relatively recent (1-3), and evidence in major orthopaedic surgery is lacking. This study assesses the influence of nutrition disorders on recovery outcomes after hip replacement.

Methods: We recruited 60 patients scheduled for primary hip replacement. Five malnutrition phenotypes were diagnosed: undernutrition, sarcopenia, obesity, sarcopenic obesity, and sarcopenic undernutrition. Outcomes were 72-hour haemoglobin (hb), 24-hour neutrophil (neut), and 10-day gait speed changes. Adjusted generalised estimating equation explored interaction effects, hierarchical multiple regression explored the variance, and elastic net regression selected the best predictors.

Results: Cohort characteristics were previously reported (4, 5). Nutrition disorder diagnosis was made in 48 (3 lost and 9 unreliable): 26 well nutrition, 9 obesity, 5 undernutrition, 2 sarcopenia, 4 sarcopenic undernutrition, 2 sarcopenic obesity. Hb significantly declined at day 2-3, with a worse drop being associated with sarcopenia at discharge (-2.37 g∙dL^-1, p=0.0024) and with high comorbidity index at day 3 (-0.32 g∙dL^-1, p=0.006). Concerning neut, older patients showed a prolonged inflammatory response on days 2 and 10 (p<0.05), and sarcopenic undernutrition was linked to a blunted response (-16.20%, p=0.0019). Older age predicted greater impairment of gait speed (p=0.032), but no significant differences based on nutrition disorders.

Conclusion: Nutrition disorders with reduced body reserves were associated with greater vulnerability to surgical stress, supporting the role of nutritional prehabilitation.

References: [1] Cederholm T et al. Clin Nutr. 2019;38(1):1-9. [2] Cruz-Jentoft AJ et al. Age Ageing. 2019;48(1):16-31. [3] Donini LM et al. Obes Facts. 2022;15(3):321-35. [4] Briguglio M et al. Nutrients. 2023;15(23). [5] Briguglio M et al. Orthopaedic Nursing. 2024.

Disclosure of Interest: None declared