Preoperative malnutrition is a risk factor for delayed recovery of mobilization after total hip arthroplasty

Introduction Many studies have examined the nutritional status and deteriorated postoperative outcomes in patients undergoing total hip arthroplasty. However, few studies have focused on nutritional status and postoperative mobility. Objective To investigate the impact of preoperative nutritional status on mobility after total hip arthroplasty. Design This was a retrospective single-institution cohort study. Setting Orthopedic inpatient rehabilitation center PARTICIPANTS: A total of 503 patients who underwent unilateral primary total hip arthroplasty from 2015 through 2019 were included. Methods Data were collected on patient demographics, comorbidities, preoperative nutritional status, and quadriceps strength. Nutritional status was assessed using the Controlling Nutritional Status (CONUT) score. Interventions Not applicable. Main outcome measure The primary outcome was postoperative mobility defined as the number of days from surgery to starting to walk independently. Results Among 503 patients undergoing total hip arthroplasty, 18.9% were classified as malnourished. Patients with malnutrition had a one-day delay in achieving mobilization compared to patients with normal nutrition (6 vs. 5 days, P=0.006). According to the Kaplan-Meier curves, patients with malnutrition had a significant delay in mobilization compared to those with normal nutrition (P=0.0003). All three Cox proportional hazards regression models showed that preoperative malnutrition was associated with a higher risk of delayed mobilization (hazard ratios 0.70-0.74). Conclusions Preoperative malnutrition as assessed by the CONUT is a significant risk factor for delayed recovery of mobilization after total hip arthroplasty. This article is protected by copyright. All rights reserved.