Objectives/Goals: Nutrition status is an overlooked, modifiable driver of total joint arthroplasty (TJA) recovery that can reduce complication rates. Therefore, we will profile preoperative nutrition status in TJA patients using integrated clinical measures, identify metrics that predict postoperative complications, and validate their clinical utility. Methods/Study Population: We will enroll 800 elective hip (THA), knee (TKA), and shoulder (TSA) arthroplasty patients. Assessments will include blood biomarkers (albumin, lymphocytes, vitamin D/A, zinc, HbA1c, lipids), bioelectrical impedance (BIA) for body composition metrics (phase angle, body fat%, skeletal muscle index: SMI, visceral adipose area: VFA), and handgrip strength (muscle quality index: MQI). Biomarkers will inform on deficiencies, immunity, and metabolic health, reflecting surgical readiness. We will compute Onodera’s Prognostic Nutritional Index (OPNI), SMI, and MQI and will evaluate infections, hospitalizations, revisions, and prolonged stay via records and encounters at 3 months and 1 year postop. Analyses will link nutrition metrics to complications to identify the strongest, actionable predictors. Results/Anticipated Results: Among the first 100 arthroplasty participants assessed (THA: 43%, TKA: 49%, TSA: 8%), 56% were male (age 66.3±10.4 yrs). Mean lymphocytes was 1.9±0.6×109/L (normal: 1.0-4.8×109/L). Zinc averaged 59.9±11.6 µg/dL (normal: 60-120 µg/dL) with 47% deficient (50.9±6.6 µg/dL) versus 53% in normal range (66.8±5.0 µg/dL). Average vitamin D was 36.3 ng/mL (sufficient: >30 ng/mL), with 42% of patients low (20.8±5.6 ng/mL) versus 48% sufficient (47.8±15.1 ng/mL). Body composition measures: BMI 30.2±5.9 kg/m2 (2% underweight, 18% normal, 27% overweight, 27% obese 1, 14% obese 2, 6% obese 3); body fat 35.1±9.4%, VFA 155.8±55.3 cm2 (healthy: <100 cm2), SMI 7.9±1.5 kg/m2, phase angle 5.0±0.8°; and MQI 1.4±0.4. Comorbidities: T2DM 18%, HTN 67%, hypercholesterolemia 28%, CVD 37%; and 8% used GLP-1 medications. Discussion/Significance of Impact: These early data show high zinc and vitamin D deficiency (47% and 42%, respectively), obesity (47% class I–III), and substantial comorbidities, underscoring the need for standardized nutrition screening in orthopedics. These findings justify targeted preop interventions and support an NIH R01 focused on reducing complications.
Kviatkovsky et al. (Wed,) studied this question.