The impact of serum albumin levels on postoperative complications in lumbar and cervical spine surgery: an analysis of the Michigan Spine Surgery Improvement Collaborative registry.

IF 2.9 2区 医学 Q2 CLINICAL NEUROLOGY Journal of neurosurgery. Spine Pub Date : 2024-09-06 Print Date: 2024-12-01 DOI:10.3171/2024.5.SPINE24113
Anisse N Chaker, Anneliese F Rademacher, Matthew Easton, Yousif Jafar, Edvin Telemi, Tarek R Mansour, Enoch Kim, Matthew Brennan, Jianhui Hu, Lonni Schultz, David R Nerenz, Jason M Schwalb, Muwaffak Abdulhak, Jad G Khalil, Richard Easton, Miguelangelo Perez-Cruet, Ilyas Aleem, Paul Park, Teck Soo, Doris Tong, Victor Chang
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Abstract

Objective: Patients with serum albumin levels < 3.5 g/dL are considered malnourished, but there is a paucity of data regarding the outcomes of patients with albumin levels > 3.5 g/dL. The objective of this study was to evaluate the effect of albumin on postoperative outcome in patients undergoing elective cervical and lumbar spine procedures.

Methods: The Michigan Spine Surgery Improvement Collaborative database was queried for lumbar and cervical fusion surgeries between January 2020 and December 2022. Patients were grouped by preoperative serum albumin levels: < 3.5 g/dL, 3.5-3.7 g/dL, 3.8-4.0 g/dL, and > 4.0 g/dL. Primary outcomes included urinary retention, ileus, dysphagia, surgical site infection (SSI), readmission within 30 and 90 days, return to the operating room, and length of stay (LOS) ≥ 4 days. Multivariate analysis was conducted to adjust for potential confounders.

Results: This study included 15,629 lumbar cases and 6889 cervical cases. Within the lumbar cohort, an albumin level of 3.5-3.7 g/dL was associated with an increased risk of readmission at 30 days (p = 0.048) and 90 days (p = 0.005) and an LOS ≥ 4 days (p < 0.001). An albumin level of 3.8-4.0 g/dL was associated with an increased risk of an LOS ≥ 4 days (p < 0.001). Within the cervical cohort, an albumin level of 3.5-3.7 g/dL was associated with an increased risk of SSI (p = 0.023), readmission at 30 days (p < 0.002) and 90 days (p < 0.001), return to the operating room (p = 0.002), and an LOS ≥ 4 days (p < 0.001). An albumin level of 3.8-4.0 g/dL was associated with an increased risk of readmission at 30 days (p = 0.012) and 90 days (p = 0.001) and an LOS ≥ 4 days (p < 0.001).

Conclusions: This study maintains that patients with hypoalbunemia undergoing spine surgery are at risk for postoperative adverse events. However, there also exist significant associations between borderline serum albumin levels of 3.5-4.0 g/dL and increased risk of postoperative adverse events.

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血清白蛋白水平对腰椎和颈椎手术术后并发症的影响:密歇根脊柱手术改进合作登记分析。
目的:血清白蛋白水平低于 3.5 g/dL 的患者被视为营养不良,但有关白蛋白水平高于 3.5 g/dL 的患者术后效果的数据却很少。本研究旨在评估白蛋白对接受颈椎和腰椎择期手术患者术后效果的影响:方法:对 2020 年 1 月至 2022 年 12 月期间接受腰椎和颈椎融合手术的患者进行密歇根脊柱手术改进协作数据库查询。根据术前血清白蛋白水平对患者进行分组:< 3.5 g/dL、3.5-3.7 g/dL、3.8-4.0 g/dL、> 4.0 g/dL。主要结果包括尿潴留、回肠梗阻、吞咽困难、手术部位感染(SSI)、30 天和 90 天内再次入院、返回手术室以及住院时间(LOS)≥ 4 天。对潜在的混杂因素进行了多变量分析:这项研究包括15629个腰椎病例和6889个颈椎病例。在腰椎病队列中,白蛋白水平为 3.5-3.7 g/dL 与 30 天(p = 0.048)和 90 天(p = 0.005)再入院风险增加以及 LOS ≥ 4 天(p < 0.001)相关。白蛋白水平为 3.8-4.0 g/dL 与 LOS ≥ 4 天的风险增加有关(p < 0.001)。在宫颈组群中,白蛋白水平为 3.5-3.7 g/dL 与 SSI(p = 0.023)、30 天(p < 0.002)和 90 天(p < 0.001)再入院、返回手术室(p = 0.002)和 LOS ≥ 4 天(p < 0.001)的风险增加有关。白蛋白水平为 3.8-4.0 g/dL 与 30 天(p = 0.012)和 90 天(p = 0.001)再入院风险增加以及 LOS ≥ 4 天(p < 0.001)相关:本研究认为,接受脊柱手术的低钾血症患者有发生术后不良事件的风险。然而,血清白蛋白水平在3.5-4.0 g/dL之间的边界线与术后不良事件风险增加之间也存在明显关联。
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来源期刊
Journal of neurosurgery. Spine
Journal of neurosurgery. Spine 医学-临床神经学
CiteScore
5.10
自引率
10.70%
发文量
396
审稿时长
6 months
期刊介绍: Primarily publish original works in neurosurgery but also include studies in clinical neurophysiology, organic neurology, ophthalmology, radiology, pathology, and molecular biology.
期刊最新文献
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