PMID- 34982418
OWN - NLM
STAT- MEDLINE
DCOM- 20220614
LR  - 20220712
IS  - 2212-1358 (Electronic)
IS  - 2212-134X (Linking)
VI  - 10
IP  - 4
DP  - 2022 Jul
TI  - Is preoperative S-albumin associated to postoperative complications and 
      readmission in patients with adult spinal deformity: a prospective analysis of 
      128 patients using the Spine AdVerse Event Severity (SAVES) system.
PG  - 893-900
LID - 10.1007/s43390-021-00467-4 [doi]
AB  - PURPOSE: To assess the association between preoperative S-albumin and 
      postoperative outcome following adult spinal deformity (ASD) surgery. METHODS: 
      All patients undergoing ASD surgery from February 1, 2017 and January 31, 2018 at 
      a single quaternary referral center were prospectively included. Adverse events 
      (AE) during admission were assessed using the Spine AdVerse Events Severity 
      (SAVES) system. Based on preoperative S-albumin, patients were categorized as 
      "normal" or "abnormal" and compared regarding postoperative outcome, adverse 
      events (AEs), 30- and 90-day readmission, revision surgery, and mortality. 
      RESULTS: A total of 128 patients aged >/= 18 years were included, and S-albumin was 
      available in 88%. Of these, 73% (n = 93) were classified as "normal", 16% 
      (n = 20) as "abnormal", and 12% (n = 15) as "missing". The "normal" albumin group 
      had less comorbidity burden [ASA score 2 (2, 3) vs 3 (2, 3), p = 0.011], higher 
      hemoglobin levels (8.4 (+/- 0.9) mmol/L vs 7.4 (+/- 1.1) mmol/L, p < 0.001), and 
      higher S-albumin (38.9 (+/- 2.7) g/L vs 31.9 (+/- 4.4) g/L, < 0.001). The rate of 
      90-day readmission was significantly increased in the "abnormal" group (65% vs 
      36%), corresponding to a relative risk increase of 1.25 (95% CI 1.02-1.52, 
      p = 0.029). Similar increased risks were found in subsequent logistic regression 
      analyses, although results were not significant in multivariable analysis 
      (p = 0.102). Comparing remaining outcome parameters, point estimates revealed 
      increased AEs, 30-day readmission, and revision in the "abnormal" albumin group, 
      although effects did not reach statistical significance. CONCLUSIONS: In a 
      prospective, consecutive, single-center cohort of 128 patients undergoing ASD 
      surgery, we found a significant association between "abnormal" preoperative 
      S-albumin and increased 90-day readmission. Furthermore, although the findings 
      were not statistically significant, we did find that AEs, 30-day readmission, and 
      revision were numerically more frequent in the "abnormal" group, suggesting an 
      expected tendency that should be further investigated. We conclude that 
      nutritional status prior to ASD surgery could be important to consider and 
      suggest validation in larger prospective cohorts. LEVEL OF EVIDENCE: Prognostic 
      II.
CI  - (c) 2022. The Author(s), under exclusive licence to Scoliosis Research Society.
FAU - Gehrchen, Mathilde Louise
AU  - Gehrchen ML
AUID- ORCID: 0000-0002-6528-1259
AD  - Spine Unit, Department of Orthopedic Surgery, Rigshospitalet, Copenhagen 
      University Hospital, Blegdamsvej 9, 2100, Copenhagen, Denmark. 
      mathilde.gehrchen@gmail.com.
FAU - Bari, Tanvir Johanning
AU  - Bari TJ
AD  - Spine Unit, Department of Orthopedic Surgery, Rigshospitalet, Copenhagen 
      University Hospital, Blegdamsvej 9, 2100, Copenhagen, Denmark.
FAU - Dahl, Benny
AU  - Dahl B
AD  - Department of Orthopedics and Scoliosis Surgery, Texas Children's Hospital and 
      Baylor College of Medicine, 6621 Fannin St., Houston, TX, 77030, USA.
FAU - Andersen, Thomas Borbjerg
AU  - Andersen TB
AD  - Spine Unit, Department of Orthopedic Surgery, Rigshospitalet, Copenhagen 
      University Hospital, Blegdamsvej 9, 2100, Copenhagen, Denmark.
FAU - Gehrchen, Martin
AU  - Gehrchen M
AD  - Spine Unit, Department of Orthopedic Surgery, Rigshospitalet, Copenhagen 
      University Hospital, Blegdamsvej 9, 2100, Copenhagen, Denmark.
LA  - eng
PT  - Journal Article
DEP - 20220104
PL  - England
TA  - Spine Deform
JT  - Spine deformity
JID - 101603979
RN  - 0 (Albumins)
SB  - IM
MH  - Adult
MH  - Albumins
MH  - Humans
MH  - *Patient Readmission
MH  - Postoperative Complications/epidemiology/etiology
MH  - Retrospective Studies
MH  - *Spine/surgery
OTO - NOTNLM
OT  - Adult spinal deformity
OT  - Adverse events
OT  - Malnutrition
OT  - Preoperative albumin
OT  - Readmission
OT  - Serum albumin
EDAT- 2022/01/05 06:00
MHDA- 2022/06/15 06:00
CRDT- 2022/01/04 12:42
PHST- 2021/06/02 00:00 [received]
PHST- 2021/12/19 00:00 [accepted]
PHST- 2022/01/05 06:00 [pubmed]
PHST- 2022/06/15 06:00 [medline]
PHST- 2022/01/04 12:42 [entrez]
AID - 10.1007/s43390-021-00467-4 [pii]
AID - 10.1007/s43390-021-00467-4 [doi]
PST - ppublish
SO  - Spine Deform. 2022 Jul;10(4):893-900. doi: 10.1007/s43390-021-00467-4. Epub 2022 
      Jan 4.