In gratitude of the loyal support of our members, the CNS is offering complimentary 2021 Annual Meeting registration to all members! Learn more.

  • Preoperative Serum Albumin Level as a Predictor of Postoperative Complication after Spine Fusion

    Final Number:
    406

    Authors:
    Owoicho Adogwa M.D. M.P.H; Terence Verla; Parastou Fatemi; Joel Martin MD; Paul Thompson BS; Kevin T. Huang MD; Maragatha Kuchibhatla PhD; Shivanand P. Lad MD PhD; Carlos Antonio Bagley MD; Oren N. Gottfried MD

    Study Design:
    Other

    Subject Category:

    Meeting: Congress of Neurological Surgeons 2014 Annual Meeting

    Introduction: The substantial prevalence of malnutrition in the hospitalized patient population has only been recently recognized. Preoperative hypoalbuminemia (serum albumin =3.5 g/dL) has been shown to be associated with increased morbidity and mortality rates in hospitalized patients. The prognostic implications and significance of hypoalbuminemia after spine fusion surgery remain unknown. In this study, we assess the predictive value of pre-operative nutritional status (serum albumin level) on post-operative complication rates.

    Methods: The medical records of 136 patients undergoing spine fusion at Duke University hospital were reviewed. Pre-operative serum albumin level was assessed on all patients and used to quantify nutritional status. Albumin less than 3.5 g/dL was recognized as hypoalbuminemia (malnourished). Patient demographics, comorbidities, and post-operative complication rates were collected. Patients were also stratified into two groups based on their etiology, namely elective degenerative/deformity versus non-elective cases. The association between pre-operative serum albumin level and post-operative complication was assessed via multivariate logistic regression analysis.

    Results: Overall, 40 (29.4%) patients experience at least one postoperative complication. Patients undergoing elective surgery had a difference in postoperative complication rates based on pre-operative albumin levels (malnourished: 35.7% vs. nourished: 11.7%, p=0.03), whereas those undergoing non-elective surgery had similar complication rates (malnourished: 46.5% vs. nourished: 42.1%, p=0.75), Table 1. For patients undergoing elective spinal surgery, logistic regression with and without propensity score adjustment for risk factors, demonstrated that preoperative serum albumin level was a significant predictor of postoperative complications (OR: 4.21, CI: 95% (1.09, 16.19), p=0.04) and (OR: 4.54, CI: 95% (1.17, 19.32), p=0.04), respectively, Table 2.

    Conclusions: Pre-operative hypoalbuminemia is an independent risk factor for postoperative complications following elective spine surgery for degenerative and deformity causes, and should be used more frequently as a prognostic tool to detect malnutrition and risk of adverse surgical outcomes.

    Patient Care: Hypoalbuminemia should be used more frequently as a prognostic tool to detect malnutrition and risk of adverse surgical outcomes.

    Learning Objectives: Pre-operative hypoalbuminemia is an independent risk factor for postoperative complications following elective spine surgery

    References:

We use cookies to improve the performance of our site, to analyze the traffic to our site, and to personalize your experience of the site. You can control cookies through your browser settings. Please find more information on the cookies used on our site. Privacy Policy