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EVALUATION OF CHANGES TO RESTING METABOLIC RATE (RMR) AND BODY COMPOSITION FOLLOWING ORTHOPEDIC SURGERY

Abstract

Orthopedic surgery creates a response by the body that stimulates a change in metabolism, including the need for energy intake and shift in muscle and fat distribution. The extent of the change has not been studied and it is unknown how accurate current dietary recommendations following surgery are. Suboptimal nutrition prior to surgery and throughout recovery can lead to increased postoperative length of stay, risk of infection, morbidity, and mortality. PURPOSE: This study determines the effect of orthopedic surgery on resting metabolic rate (RMR). METHODS: Patients were recruited from preoperative clinical visits and identified as eligible if they were >15 years old and were scheduled to undergo orthopedic surgery within 1 month of screening date. Each visit assessed rested and fasted total body and segmental body composition using a standing platform bioelectrical impedance analysis (BIA) device and resting metabolic rate using indirect calorimetry. Actual RMR (aRMR) was compared to estimated values from the Harris-Benedict (BMRHB) and Cunningham (BMRCu) equations using a 1-way ANOVA at baseline for 19 participants [F=15; age (yrs): 40.3±16.8; height (cm): 170.0±8.6; body mass (kg): 73.1±15.0]. Additionally, aRMR, lean body mass (LBM), and appendicular lean mass (ALM) was evaluated over time from pre-surgery, and 3-week, 6-week, and 12-weeks post operatively in a subset of 6 participants using a one-way ANOVA. A predetermined level of significance was set at 0.05 for all comparisons. RESULTS: The aRMR and BMRCu were significantly greater than BMRHB (p=0.007 and p

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