# Lymphocyte Count, Serum Albumin and Transferrin Levels in Patients Undergoing Total Knee Arthroplasty

## TL;DR

This study found that 17.7% of patients undergoing knee replacement surgery showed signs of preoperative malnutrition, linked to factors like age and weight.

## Contribution

The study identifies specific biomarkers and risk factors for malnutrition in TKA patients and highlights the need for larger studies.

## Key findings

- 17.7% of TKA patients showed preoperative malnutrition based on lymphocyte, albumin, and transferrin levels.
- Older age, anemia, and low or normal weight were independently associated with higher malnutrition prevalence.
- No significant link was found between malnutrition and post-surgical complications like infection.

## Abstract

Describe the prevalence of preoperative malnutrition in individuals undergoing primary TKA and to assess its association with age, sex, body mass index (BMI), and comorbidities, as well as the risk of prolonged postsurgical hospitalization, early prosthetic joint infection (PJI), or readmission.

We conducted a cohort study of TKAs performed between 2014 and 2016. Preoperative malnutrition was defined as a total lymphocyte count < 1,500 cells/mm
3
, a serum albumin concentration < 3.5 g/dL, or a transferrin concentration < 200 mg/dL within the six months before surgery.

Out of the 2080 TKAs performed, 1099 had valid lymphometry, albumin, and transferrin data and were included in the analysis. The prevalence of malnutrition was 17.7%. Independent factors associated with a higher prevalence of malnutrition were age (OR = 1.03; 95% CI = (1.01–1.05)), anemia (1.55 (1.05–2.28)), low weight (3.13 (1.50–6.50)), and normal weight (1.85 (1.21–2.82)). Diabetes mellitus was inversely associated with malnutrition (0.60 (0.38–0.96)). Early PJI was diagnosed in 18 (1.6%) participants. There was no statistically significant and independent association between malnutrition and postsurgical complications.

Altered lymphocyte count, serum albumin, and transferrin levels is common among individuals undergoing TKA, particularly in older patients, those with anemia, and individuals with normal or low weight. Future studies with larger sample sizes are needed to better assess the relationship between malnutrition and adverse outcomes following TKA.