Abstract

MASATU, DM  and  MCHARO, CN. Predictive values of serum nutritional indices for early postoperative wound infections in surgically treated closed femoral fractures. SA orthop. j. [online]. 2010, vol.9, n.4, pp.63-67. ISSN 2309-8309.

BACKGROUND: Laboratory assessments of nutritional status consisting of evaluation of serum albumin and total lymphocytes count (TLC) are valid tests of a patient's nutritional status. This study evaluated these indices and the findings were correlated with the occurrence of early surgical site infection (SSI). METHODS: This was a prospective study conducted on 100 patients with closed femoral fractures for a period of ten months. Blood samples were taken to determine levels of serum albumin, total lymphocytes count and for human immunodeficiency virus (HIV). Postoperatively, body mass index (BMI) was calculated and wounds were examined regularly for signs of SSI. RESULTS: On the basis of the albumin index, 25% of the patients had malnutrition and the infection rate in this group was 28%. Malnutrition as per TLC was 3% with an infection rate of 33.3%. Only one patient was malnourished when both albumin and TLC indices were considered and this patient developed SSI. Risk of developing SSI was about 10 times in those with albumin depletion, four times in those with reduced TLC and 12 times when both indices were low. Significant association was seen in low albumin levels (P = 0.000). CONCLUSIONS: Patients at risk of SSI can be identified pre-operatively using relatively inexpensive laboratory tests of nutritional parameters such as serum albumin. Preventive measures like nutritional support and prophylactic antibiotics can then be initiated.

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