Prevalence of Nutritionally at Risk and Proinflammatory States in Patients Undergoing Elective Shoulder Surgery

Background: The effect of malnutrition on patients undergoing orthopaedic surgery has been a recent topic of interest. The purpose of this study was to describe the prevalence and risk factors of patients who are nutritionally at risk (NAR) of becoming malnourished and its relationship with proinflammatory states (PIS), demographic risk factors, and comorbid conditions in patients undergoing shoulder surgery. Methods: This study was a single-institution retrospective study of 42 patients with nutrition and inflammatory labs obtained before elective shoulder surgery from September 2023 to April 2024. Patients were considered NAR if they had at least one abnormal level of the following: albumin, prealbumin, or vitamin D. Patients were considered as having a PIS if they had at least one abnormal level of the following: CRP, transferrin, or platelet:lymphocyte ratio. Unpaired t -test and odds ratio (OR) were used to assess associations between demographics, laboratory abnormalities, and comorbid conditions with NAR and PIS. Results: Of the 42 patients, five (11.9%) were NAR, whereas 26 (61.9%) had proinflammatory labs. NAR patients had significantly elevated BMI (37.0 vs 29.0, P = 0.009, OR: 1.75 [1.08 to 2.83]). Patients who were NAR had greater odds of having a greater number of total laboratory abnormalities (1.46 vs 3.60, P = 0.069, OR: 2.56 [1.18 to 5.54]). The patients who met criteria for PIS were significantly more likely to have a greater number of total abnormal labs drawn from the standard preoperative laboratory set (0.69 vs 2.35, P < 0.001, OR: 3.67 [1.51 to 8.94]). No significant differences in comorbidities, alcohol use, or smoking status were found between any group. Conclusion: Our findings show a greater overall prevalence of NAR state in shoulder surgery patients than previously described rates of malnutrition. Risk factors for being NAR include elevated BMI and greater overall number of abnormal nutrition and inflammatory labs. Level of Evidence: Level III.