Preoperative Nutritional Status Screened by MNA-SF Predicts Major Complications in Elderly Patients Undergoing Lumbar Fusion Surgery.

IF 3.5 3区医学 Q2 GERIATRICS & GERONTOLOGY Clinical Interventions in Aging Pub Date : 2024-12-03 eCollection Date: 2024-01-01 DOI:10.2147/CIA.S481610

Di Han, Shuai-Kang Wang, Peng Cui, Chao Kong, Peng Wang, Shi-Bao Lu

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Abstract

Purpose: To investigate the role of Mini Nutritional Assessment-Short Form (MNA-SF) in predicting postoperative complications in older patients (≥75 years) undergoing lumbar fusion surgery.

Patients and methods: Patients who had undergone posterior lumbar fusion surgery between June 2019 and September 2021 were enrolled. Those with an MNA-SF score of 12 or higher were categorized as the Nourished group, while those with a score less than 12 were placed in the Malnutrition-Risk group. Preoperative, intraoperative, and postoperative variables between groups were compared. Patients were then re-classified based on the presence of major complications, univariate analysis and multivariate logistic regression was used to identify risk factors for major complications.

Results: A total of 240 patients were enrolled, with 182 in the Nourished group and 58 in the Malnutrition-Risk group. The Malnutrition-Risk group exhibited a higher incidence of major complications (46.6% vs 23.1%, p = 0.001) and comprehensive complications index (18.42 ± 18.00 vs 12.65 ± 15.87, p = 0.021), Oswestry Disability Index (27.52 ± 23.44 vs 20.45 ± 20.42, p = 0.029) and longer recovery times (12.53 days vs 10.15 days, p =0.033). Length of stay (LOS) were also increased in the Malnutrition-Risk group (19.22 ± 10.67 vs 16.04 ± 7.69, p = 0.014). Multiple regression analysis identified nutritional risk and malnutrition, as assessed by MNA-SF, as independent factors associated with postoperative major complications (OR 2.81, 95% CI 1.42-5.53, p = 0.003).

Conclusion: Preoperative nutritional risk or malnutrition is an independent risk factor for major complications among older patients undergoing posterior lumbar fusion surgery. The MNS-SF emerges as a convenient and effective tool for promptly screening the nutritional status of older patients, prompting subsequent nutritional evaluation or intervention before surgery.

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目的：研究迷你营养评估短表（MNA-SF）在预测接受腰椎融合手术的老年患者（≥75岁）术后并发症中的作用：纳入2019年6月至2021年9月期间接受后路腰椎融合手术的患者。MNA-SF评分达到或超过12分的患者被归为营养组，评分低于12分的患者被归为营养不良-风险组。比较了各组之间的术前、术中和术后变量。然后根据是否出现主要并发症对患者进行重新分类，并使用单变量分析和多变量逻辑回归来确定主要并发症的风险因素：共有 240 名患者入组，其中营养不良组 182 人，营养不良-风险组 58 人。营养不良-风险组的主要并发症发生率更高（46.6% vs 23.1%，p = 0.001），综合并发症指数（18.42 ± 18.00 vs 12.65 ± 15.87，p = 0.021）、Oswestry残疾指数（27.52 ± 23.44 vs 20.45 ± 20.42，p = 0.029）和恢复时间更长（12.53天 vs 10.15天，p =0.033）。营养不良-风险组的住院时间（LOS）也有所增加（19.22 ± 10.67 vs 16.04 ± 7.69，p = 0.014）。多元回归分析发现，由 MNA-SF 评估的营养风险和营养不良是与术后主要并发症相关的独立因素（OR 2.81，95% CI 1.42-5.53，p = 0.003）：结论：术前营养风险或营养不良是接受后路腰椎融合手术的老年患者出现主要并发症的独立风险因素。MNS-SF 是一种方便有效的工具，可及时筛查老年患者的营养状况，以便在术前进行营养评估或干预。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Interventions in Aging GERIATRICS & GERONTOLOGY-

CiteScore

6.80

自引率

2.80%

发文量

193

审稿时长

6-12 weeks

期刊介绍： Clinical Interventions in Aging, is an online, peer reviewed, open access journal focusing on concise rapid reporting of original research and reviews in aging. Special attention will be given to papers reporting on actual or potential clinical applications leading to improved prevention or treatment of disease or a greater understanding of pathological processes that result from maladaptive changes in the body associated with aging. This journal is directed at a wide array of scientists, engineers, pharmacists, pharmacologists and clinical specialists wishing to maintain an up to date knowledge of this exciting and emerging field.