Academic Journal

Improved outcomes with perioperative dietitian-led interventions in patients undergoing total joint arthroplasty: A systematic review.

التفاصيل البيبلوغرافية
العنوان: Improved outcomes with perioperative dietitian-led interventions in patients undergoing total joint arthroplasty: A systematic review.
المؤلفون: Yee, Steven L., Schmidt, R. Cole, Satalich, James, Krumme, John, Golladay, Gregory J., Patel, Nirav K.
المصدر: Journal of Orthopaedics; Oct2024, Vol. 56, p12-17, 6p
مصطلحات موضوعية: MEDICAL information storage & retrieval systems, OCCUPATIONAL roles, TREATMENT effectiveness, SYSTEMATIC reviews, MEDLINE, ARTIFICIAL joints, ELECTIVE surgery, MEDICAL databases, PERIOPERATIVE care, DIET therapy
مستخلص: Nutritional assessment is important for optimization of patients undergoing elective total joint arthroplasty (TJA). Preoperative nutritional intervention is a potentially modifiable optimization target, but the outcomes of such intervention are not well-studied. The purpose of this study is to assess the impact of nutritional interventions on elective TJA outcomes. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were utilized to perform a systematic review of the Ovid Medline, Embase, and Cochrane Library systems. Included studies were comprised of patients greater than 18 years of age undergoing a primary unilateral TJA who received a perioperative dietitian-led intervention. Data analyzed included nutritional intervention protocol, patient demographics, length of stay (LOS), postoperative labs and complications, among others. Our initial search identified a total of 1766 articles. Four studies representing 5006 patients met inclusion criteria. The studies utilized a protein-dominant diet, with or without a carbohydrate solution accompanied by dietitian assessment or education. The 4 studies found that the intervention group had significantly decreased LOS, fewer albumin infusions, less wound drainage, lower rates of hypocalcemia and hypokalemia, reduced C-reactive protein (CRP) values, improved time out of bed, and decreased overall costs. The findings support the potential benefits of perioperative dietitian-led intervention on key outcomes for patients undergoing primary TJA. Surgeons should consider nutritional intervention in their preoperative optimization protocols. Future studies could help elucidate the optimum nutritional regimens and monitoring for idealized intervention and surgical timing. CRD4202338494. [ABSTRACT FROM AUTHOR]
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قاعدة البيانات: Complementary Index
الوصف
تدمد:25899082
DOI:10.1016/j.jor.2024.04.021