Brian J Christensen1, Andrew G Chapple2, Brett J King3. 1. Chief Resident, Department of Oral and Maxillofacial Surgery, Louisiana State University Health Sciences Center, New Orleans, LA. 2. Assistant Professor, Department of Biostatistics, Louisiana State University Health Sciences Center, New Orleans, LA. 3. Assistant Professor, Department of Oral and Maxillofacial Surgery, Louisiana State University Health Sciences Center, New Orleans, LA. Electronic address: bking6@lsuhsc.edu.
Abstract
PURPOSE: Fracture healing relies on the body to coordinate an inflammatory and anabolic reaction to re-establish osseous union. Although many factors affect this process or even disrupt it, the role of the body's nutritional reserves is not well understood. The purposes of this study were to describe the weight changes and to identify trends in laboratory values commonly used in nutritional assessment during mandibular fracture treatment. MATERIALS AND METHODS: A prospective cohort study was designed. The study cohort included patients who sustained a mandibular fracture from September 1, 2017, to March 31, 2018. The primary outcome variable was the percentage weight change from baseline. Secondary outcome variables included serum albumin and serum prealbumin levels. Weight change was analyzed using a linear mixed model. Paired Wilcoxon tests were used to compare laboratory values with baseline levels. RESULTS: Thirty-nine patients met the inclusion criteria with sufficient follow-up data for analysis. The linear mixed model predicted a peak weight loss of 4.1% of the initial body weight by day 34. The serum prealbumin level increased over the study period (P < .001), and the albumin level was increased from baseline at week 3 (P < .05) but not significantly different from baseline after that time. CONCLUSIONS: During the course of treatment for mandibular fractures, patients lost an average of more than 4% of their body weight. However, the study did not show any meaningful change in nutritional laboratory values. Although it is important for patients and surgeons to be able to anticipate a weight loss of about 4 to 5% during mandibular fracture treatment, it is unlikely that this represents a large challenge to the nutritional status of patients.
PURPOSE: Fracture healing relies on the body to coordinate an inflammatory and anabolic reaction to re-establish osseous union. Although many factors affect this process or even disrupt it, the role of the body's nutritional reserves is not well understood. The purposes of this study were to describe the weight changes and to identify trends in laboratory values commonly used in nutritional assessment during mandibular fracture treatment. MATERIALS AND METHODS: A prospective cohort study was designed. The study cohort included patients who sustained a mandibular fracture from September 1, 2017, to March 31, 2018. The primary outcome variable was the percentage weight change from baseline. Secondary outcome variables included serum albumin and serum prealbumin levels. Weight change was analyzed using a linear mixed model. Paired Wilcoxon tests were used to compare laboratory values with baseline levels. RESULTS: Thirty-nine patients met the inclusion criteria with sufficient follow-up data for analysis. The linear mixed model predicted a peak weight loss of 4.1% of the initial body weight by day 34. The serum prealbumin level increased over the study period (P < .001), and the albumin level was increased from baseline at week 3 (P < .05) but not significantly different from baseline after that time. CONCLUSIONS: During the course of treatment for mandibular fractures, patients lost an average of more than 4% of their body weight. However, the study did not show any meaningful change in nutritional laboratory values. Although it is important for patients and surgeons to be able to anticipate a weight loss of about 4 to 5% during mandibular fracture treatment, it is unlikely that this represents a large challenge to the nutritional status of patients.
Authors: David A Cardenas; Cristian G García; Cristhian García; Jose L Moreno; Milton O Sandoval; Dorian I Villafuerte Journal: Trauma Case Rep Date: 2021-02-10