Association of GLIM-defined malnutrition with postoperative complications in older patients undergoing hip...

Malnutrition is common in older patients undergoing hip arthroplasty and may adversely affect postoperative recovery. The global leadership initiative on malnutrition (GLIM) criteria provide a standardized framework for nutritional diagnosis, but evidence regarding their prognostic value in older hip arthroplasty patients remains limited. This study evaluated the association between GLIM-defined malnutrition and postoperative complications in this population. This retrospective observational study included patients aged 60 years or older who underwent primary hip arthroplasty between January 2022 and December 2025. Nutritional status was assessed using the GLIM criteria. Patients with malnutrition were matched 1:2 with those without malnutrition according to age, sex, surgical year, and primary indication for hip arthroplasty. The primary outcome was postoperative complications during hospitalization or within 30 days after surgery. Secondary outcomes included length of hospital stay, intensive care unit admission, and perioperative blood transfusion. Univariable and multivariable logistic regression analyses were performed to identify factors associated with postoperative complications. The matched cohort comprised 168 patients, including 56 with malnutrition and 112 without malnutrition. The malnutrition group had lower body weight, body mass index, hemoglobin, albumin, total lymphocyte count, and total protein, as well as higher C-reactive protein levels. Postoperative complications occurred more frequently in the malnutrition group than in the non-malnutrition group (42.9% vs 20.5%, P = .002). Length of hospital stay and perioperative blood transfusion rate were also higher in the malnutrition group. Multivariable analysis showed that GLIM-defined malnutrition was independently associated with postoperative complications (adjusted odds ratio = 2.74, 95% confidence interval: 1.23-6.09, P = .013). GLIM-defined malnutrition was independently associated with postoperative complications in older patients undergoing hip arthroplasty. Preoperative GLIM-based nutritional assessment may improve perioperative risk stratification in this population.