What is it about?
A malnutritional status prior to orthopedic surgery is known to be associated with worse outcomes. The primary criteria for addressing malnutrition in clinical settings appear to be well recognized, being three factors termed “phenotypic” criteria (non-volitional weight loss, low body mass index (BMI), reduced lean mass) and two factors being “etiologic” in nature (low food intake, disease burden). However, also laboratory markers, such as total lymphocyte count (TLC), albumin, pre-albumin, iron metabolism, and vitamin D, could be used as a complement to the abovementioned nutritional examination, even if they might be unreliable by themselves.
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Why is it important?
An attentive peri-operative program could take years to be integrated in a specific setting, but would certainly guarantee the optimal medical model. The low risk profile compared to the great potential benefits warrant the consideration of incorporating a comprehensive nutritional support program in orthopedic surgery.
Perspectives
Future researchers should investigate each nutritional intervention in their own setting, initially considering each single component, and successively integrating multiple interventions and multidisciplinary approaches. Peri-operative dietitian nutritionists are invited to observe, investigate, and report their results with the highest level of detail, especially for the following items.
Dr. M. Briguglio
IRCCS Ospedale Galeazzi - Sant'Ambrogio
Read the Original
This page is a summary of: Nutritional support for enhanced recovery programs in orthopedics: Future perspectives for implementing clinical practice, Nutrition Clinique et Métabolisme, September 2019, Elsevier,
DOI: 10.1016/j.nupar.2019.04.002.
You can read the full text:
Resources
L’importanza di un approccio nutrizionale a 360 gradi nel paziente ortopedico
Negli ultimi 15 anni, i centri ortopedici hanno iniziato ad applicare un approccio multidisciplinare nella gestione del paziente sottoposto a chirurgia ortopedica di anca, ginocchio, e colonna. Tuttavia, ci sono ancora molte possibilità di implementazione dei concetti alla base del “recupero rapido” nei cosiddetti percorsi fast track.
The mutual features between the astronaut and the orthopedic patient
Whether we are dealing with aged orthopedic patients or space travelers, a nutrition professional specialized in the musculoskeletal system may be the common handler able to drive two trains without derailing.
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