Preoperative Ascorbic Acid Levels in Proximal Femur Fracture Patients Have No Postoperative Clinical Impact, While Ascorbic Acid Levels upon Discharge Have a Major Effect on Postoperative Outcome
Abstract
:1. Introduction
2. Experimental Section
2.1. Ethics Statement
2.2. Patient Population and Surveys
2.3. Blood Sampling and Ascorbic Acid Analysis
2.4. Statistical Analysis
3. Results
3.1. Basic Clinical Parameters of the Study Population
3.2. Ascorbic Acid Plasma Concentration
3.3. Ascorbic Acid Concentrations during Hospitalization
3.4. Delta
3.5. NRS Status
3.6. MNA Status
3.7. Food Score
3.8. Postoperative Complications
3.8.1. Postoperative Complications and AA Status
3.8.2. Postoperative Complications and NRS Status
3.8.3. Postoperative Complications and MNA Status
3.8.4. Postoperative Complications and Clinical Parameters
3.8.5. Mortality within 12 Months after Surgery
3.9. Clinical Parameters
4. Discussion
4.1. Ascorbic Acid Status
4.2. Clinical Outcome
4.3. Clinical Correlations to Postoperative Complications and Mortality
4.4. Clinical Findings Regarding the Preoperative AA Status
5. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Clavien-Dindo Grade | Description |
---|---|
0 | No complications. |
1 | Any deviation from the normal postoperative course without the need for pharmaceutical treatment other than the “allowed therapeutic regiments”, or surgical, endoscopic and radiological intervention. |
2 | Requiring pharmacological treatment with drugs beyond those allowed for grade I complications. Blood transfusions or total parenteral nutrition are also included. |
3 | Requiring surgical, endoscopic or radiological intervention. |
4 | Life threatening complication requiring critical care management. |
5 | Death. |
Plasma Levels | AA Status |
---|---|
>80 µmol/L | high AA concentrations |
70–80 µmol/L | optimal AA status |
50–69.9 µmol/L | adequate AA status |
23–49.9 µmol/L | suboptimal AA status |
11–22.9 µmol/L | mild AA deficiency |
<11 µmol/L | severe AA deficiency |
CG 1 | CG 2 | SG T1 | SG 6–8 Weeks | SG 12 Months | |
---|---|---|---|---|---|
Average Age in Years | 22.93 ± 2.09 | 76.42 ± 6.52 | 83.96 ± 6.24 | ||
Living conditions | |||||
Alone | 8/25 (32.0%) | 3/18 (16.7%) | 3/15 (20.0%) | ||
+1 person | 12/25 (48.0%) | 9/18 (50.0%) | 10/15 (66.7%) | ||
Nursing home | 5/25 (20.0%) | 3/18 (16.7%) | 2/15 (13.3%) | ||
Hospital | 0/25 (0.0%) | 3/18 (16.7%) | 0/15 (0.0%) | ||
Access to food | |||||
Self-sufficient | 100% | 21/24 (87.5%) | 12/25 (48.0%) | 5/18 (27.8%) | 7/15 (46.7%) |
Private support | 0% | 2/24 (8.3%) | 5/25 (20.0%) | 3/18 (16.7%) | 3/15 (20.0%) |
Professional ambulatory aid | 0% | 1/24 (4.2%) | 3/25 (12.0%) | 3/18 (16.7%) | 3/15 (20.0%) |
Professional stationary support | 0% | 0/24 (0.0%) | 5/25 (20.0%) | 7/18 (38.9%) | 2/15 (13.3%) |
Mobility | |||||
Walking | 100% | 18/24 (75.0%) | 12/25 (48.0%) | 0% | 3/15 (20.0%) |
Crutches | 0% | 2/24 (8.3%) | 3/25 (12.0%) | 5/18 (27.8%) | 3/15 (20.0%) |
Rollator | 0% | 3/24 (12.5%) | 9/25 (36.0%) | 7/18 (38.9%) | 8/15 (53.3%) |
Wheelchair | 0% | 1/24 (4.2%) | 1/25 (4.0%) | 3/18 (16.7%) | 1/15 (6.7%) |
Bedridden | 0% | 0/24 (0.0%) | 0/25 (0.0%) | 3/18 (16.7%) | 0/15 (0.0%) |
Level of care | |||||
No care needed | 16/25 (64.0%) | 10/18 (55.6%) | 7/15 (46.7%) | ||
1st degree | 5/25 (20.0%) | 5/18 (27.8%) | 3/15 (20.0%) | ||
2nd degree | 1/25 (4.0%) | 0/18 (0.0%) | 4/15 (26.7%) | ||
3rd degree | 3/25 (12.0%) | 3/18 (16.7%) | 1/15 (6.7%) |
Severity Level | Description | Clavien-Dindo Grade |
---|---|---|
0 | No complications | 0 |
1 | Mild complications | 1, 2 |
2 | Severe complications (including death) | 3, 4, 5 |
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Hill-Mündel, K.; Schlegl, J.; Biesalski, H.K.; Ehnert, S.; Schröter, S.; Bahrs, C.; Nohr, D.; Nüssler, A.K.; Ihle, C. Preoperative Ascorbic Acid Levels in Proximal Femur Fracture Patients Have No Postoperative Clinical Impact, While Ascorbic Acid Levels upon Discharge Have a Major Effect on Postoperative Outcome. J. Clin. Med. 2020, 9, 66. https://doi.org/10.3390/jcm9010066
Hill-Mündel K, Schlegl J, Biesalski HK, Ehnert S, Schröter S, Bahrs C, Nohr D, Nüssler AK, Ihle C. Preoperative Ascorbic Acid Levels in Proximal Femur Fracture Patients Have No Postoperative Clinical Impact, While Ascorbic Acid Levels upon Discharge Have a Major Effect on Postoperative Outcome. Journal of Clinical Medicine. 2020; 9(1):66. https://doi.org/10.3390/jcm9010066
Chicago/Turabian StyleHill-Mündel, Katharina, Johannes Schlegl, Hans Konrad Biesalski, Sabrina Ehnert, Steffen Schröter, Christian Bahrs, Donatus Nohr, Andreas K. Nüssler, and Christoph Ihle. 2020. "Preoperative Ascorbic Acid Levels in Proximal Femur Fracture Patients Have No Postoperative Clinical Impact, While Ascorbic Acid Levels upon Discharge Have a Major Effect on Postoperative Outcome" Journal of Clinical Medicine 9, no. 1: 66. https://doi.org/10.3390/jcm9010066