You are here


Lab Half-Life Normal Mild Moderate Severe
Albumin (mg/dL) 21 days 3.5-5.0 2.8-3.5 2.1-2.7 <2.1
Transferrin (mg/dL) 8-9 days 200-400 150-200 100-150 <100
Prealbumin (mg/dL) 2 days 16-30 10-15 5-10 <5
Total Lymphcyte count       <1,500/mm3  
Zinc       <95 μg/dL  

BMI <18; BMI is calculated using the equation Wt (kg)/ht (m2).


  • transferrin levels less than 200 mg/dL, albumin less than 3.5 g/dL, or a total lymphocyte count less than 1500 cells/mm3.
  • Patients that are malnourished have a 5-7x higher risk of major wound complications.
  • Obese patients are also commonly defienct in Vitamin D (92.9%) and iron (36.2% to 56.9%).
  • Dietary protein has been the primary modifiable intervention
  • Vitamin A, C, and D, zinc, and copper supplementation has also been associated with improved outcomes.

Serum albumin

  • <3.5 g/dL associated with poor surgical outcome, unfavorable prognosis, increased cost
    <2.5 g/dL associated with increased rates of morbidity and mortality.
Malnutrition References
  • Wagner ER, Kamath AF, Fruth KM, Harmsen WS, Berry DJ. Effect of Body Mass Index on Complications and Reoperations After Total Hip Arthroplasty. JBJS 2016.
  • Cross MB, Yi PH, Thomas CF, Garcia J, Della Valle, CJ. Evaluation of Malnutrition in Orthopaedic Surgery. J Am Acad Orthop Surg 2014.
  • Huang R, Greenky M, Kerr GJ, Austin MS, Parvizi J. The Effect of Malnutrition on Patients Undergoing Elective Joint Arthroplasty. J of Arthroplasty 2013.


The information on this website is intended for orthopaedic surgeons.  It is not intended for the general public. The information on this website may not be complete or accurate.  The eORIF website is not an authoritative reference for orthopaedic surgery or medicine and does not represent the "standard of care".  While the information on this site is about health care issues and sports medicine, it is not medical advice. People seeking specific medical advice or assistance should contact a board certified physician.  See Site Terms / Full Disclaimer