Related Experiment Video
Updated: Jan 12, 2026
Novel Diagnostics in Revision Arthroplasty: Implant Sonication and Multiplex Polymerase Chain Reaction
Published on: December 3, 2017
Association of Admission Nutritional Status Evaluated by the Controlling Nutritional Status Score With Periprosthetic
Haichuan Guo1, Zhenbang Yang1, Dongwei Wu1
1Department of Orthopedic Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, P.R. China; Orthopedic Research Institute of Hebei Province, Key Laboratory of Biomechanics of Hebei Province, Shijiazhuang, Hebei, P.R. China.
Insights
Admission malnutrition increases the risk of periprosthetic joint infection (PJI) after total joint arthroplasty (TJA). Early nutrition screening can help identify at-risk patients for PJI prevention strategies.
Area of Science:
- Orthopedics
- Infectious Diseases
- Nutritional Science
Background:
- Periprosthetic joint infection (PJI) is a serious complication following total joint arthroplasty (TJA).
- The link between preoperative nutritional status and PJI risk is not well-established.
- Limited evidence exists on the association between malnutrition at admission and PJI after TJA.
Purpose of the Study:
- To investigate the association between admission nutritional status and the risk of developing PJI within one year post-TJA.
- To determine if malnutrition identified at admission is an independent risk factor for PJI.
- To explore the dose-response relationship between nutritional status scores and PJI risk.
Main Methods:
- Prospective data from 10,775 TJA patients (October 2014 - December 2020) at a Chinese tertiary orthopedic center.
- Malnutrition assessed using the Controlling Nutritional Status (CONUT) score.
- PJI defined by 2014 Musculoskeletal Infection Society (MSIS) criteria; analyzed via medical records and follow-up data.
- Restricted cubic splines (RCS) and propensity score matching (PSM) used for analysis.
Main Results:
- A significant positive correlation was observed between higher CONUT scores and increased PJI risk (P < 0.001).
- Malnutrition (CONUT score ≥ 3) was independently associated with a 70% higher risk of PJI (OR 1.70, 95% CI 1.045-2.767).
- Findings remained robust after inverse probability treatment weighting (IPTW) and sensitivity analyses.
Conclusions:
- Admission malnutrition is a significant independent risk factor for PJI after TJA.
- Implementing nutrition screening upon admission is recommended for patient counseling and PJI prevention.
- Early identification of malnutrition can inform targeted interventions to reduce PJI incidence.
Background:
The relationship between admission malnutrition and periprosthetic joint infection (PJI) after total joint arthroplasty (TJA) remains unclear due to limited evidence. This study aimed to assess the association between admission nutritional status and PJI risk within one year after TJA.
Methods:
This exploratory analysis of the prospective collection of data from TJA patients was derived from a database of a tertiary orthopedic referral center from October 1, 2014, to December 31, 2020, in China. Admission malnutrition is assessed by the controlling nutritional status (CONUT) score. The main outcome was PJI, defined according to the 2014 Musculoskeletal Infection Society (MSIS) consensus criteria, determined by review of index hospitalization medical records, microbiology laboratory reports, and readmission records for PJI treatment within one year after discharge. A restricted cubic spline (RCS) was performed to visualize the dose-response relationship between the admission CONUT score and PJI risk. The Youden index was used to identify the optimal cutoff value. Propensity score matching and univariate conditional logistic regressions were used to evaluate the association of preoperative malnutrition with PJI risk. There were 10,775 patients included, with a PJI incidence of 1.01%.
Results:
The RCS curve illustrated a significant positive correlation between the admission CONUT score and the risk of PJI (P overall < 0.001). Admission malnutrition assessed by the CONUT score ≥ 3 was independently associated with a 70% increased risk of PJI (95% confidence interval [CI], 1.045 to 2.767; P = 0.033). Additionally, the results remain robust after inverse probability treatment weighting (IPTW) and sensitivity analysis.
Conclusions:
Admission malnutrition is an independent risk factor for PJI after TJA, and nutrition screening on admission is expected to aid admission counseling.
More Related Videos
Related Concept Videos
01:23Peripheral Artery Disease V: Postoperative Nursing Management
01:30Inflammatory Bowel Disease III: Diagnostic Studies and Management I-Nutritional Therapy
Diagnostic studies
A colonoscopy is the definitive screening test, distinguishing ulcerative colitis from other colon diseases with similar symptoms. During a colonoscopy test, inflamed mucosa with exudate ulcerations can be observed, and biopsies are taken to determine the histologic characteristics of the...
01:27Urinary Tract Calculi IV: Nutrition Therapy and Prevention
01:26Factors Affecting the Risk of Infection
The integrity and count of the white blood cells help the body resist pathogens and fight infection. When impaired, it reduces the body's resistance to pathogens. The acidic pH levels of the gastrointestinal, genitourinary tracts, and skin...
01:26Peripheral Artery Disease IV: Nursing Management
01:27Peripheral Artery Disease III: Interprofessional Care