PMID- 38258979
OWN - NLM
STAT- MEDLINE
DCOM- 20240328
LR  - 20240328
IS  - 1528-1159 (Electronic)
IS  - 0362-2436 (Print)
IS  - 0362-2436 (Linking)
VI  - 49
IP  - 8
DP  - 2024 Apr 15
TI  - Comparison of Four Nutritional Screening Tools for Predicting Postoperative 
      Adverse Events Following Degenerative Spinal Deformity Surgery.
PG  - 536-546
LID - 10.1097/BRS.0000000000004933 [doi]
AB  - STUDY DESIGN: A retrospective study. OBJECTIVE: To compare the mini nutritional 
      assessment-short form (MNA-SF), geriatric nutritional risk index, prognostic 
      nutritional index (PNI), and preoperative serum albumin level as predictors of 
      postoperative adverse events (AEs) in degenerative spine deformity (DSD) 
      patients. SUMMARY OF BACKGROUND DATA: Although various nutritional screening 
      tools have been well evaluated in patients undergoing spinal fusion surgery, the 
      most suitable tool for the DSD population remains uncertain at present. PATIENTS 
      AND METHODS: The authors reviewed consecutive patients who underwent 
      thoracolumbar fusion surgery for DSD between August 2016 and May 2023. Four 
      screening tools were used to assess preoperative nutritional status. Patients 
      were divided into two categories according to each screening tool, and the four 
      screening tools were compared regarding their predictive power for postoperative 
      AEs, including the rates of extended length of hospital stays (LOS), 
      complications, and readmission within three months. Physical functional 
      indicators such as time to first ambulation, nonhome discharge, and postoperative 
      LOS were assessed as secondary outcome measures. A multivariable logistic 
      regression analysis was used to identify factors associated with postoperative 
      AEs. RESULTS: A total of 228 patients were included. The demographic 
      characteristics, underlying disease, and magnitude of correction were not 
      significantly different between well-nourished and malnourished groups. The 
      nutritional risks shown by MNA-SF and albumin level were significantly associated 
      with infectious complications ( P <0.05). The nutritional risk shown by MNA-SF 
      was significantly associated with nonhome discharge, prolonged postoperative LOS 
      (12.5+/-8.2 vs. 10.3+/-6.1, P =0.039), and delayed ambulation (3.7+/-2.1 vs. 2.2+/-1.8, P 
      =0.001). Multivariable logistic regression revealed that PNI <50 was 
      significantly associated with total AEs and minor AEs after DSD surgery. 
      CONCLUSIONS: PNI was significantly associated with the incidence of total AEs and 
      minor AEs, while preoperative albumin level and MNA-SF were more effective in 
      predicting postoperative infectious complications and delayed recovery of 
      physical function, respectively. LEVEL OF EVIDENCE: Level III.
CI  - Copyright (c) 2024 The Author(s). Published by Wolters Kluwer Health, Inc.
FAU - Wang, Shuai-Kang
AU  - Wang SK
AD  - Department of Orthopedics, Xuanwu Hospital, Capital Medical University, Beijing, 
      China.
AD  - National Clinical Research Center for Geriatric Diseases, Beijing, China.
FAU - Li, Jun
AU  - Li J
AD  - Department of Orthopedics, Xuanwu Hospital, Capital Medical University, Beijing, 
      China.
AD  - National Clinical Research Center for Geriatric Diseases, Beijing, China.
FAU - Wang, Peng
AU  - Wang P
AD  - Department of Orthopedics, Xuanwu Hospital, Capital Medical University, Beijing, 
      China.
AD  - National Clinical Research Center for Geriatric Diseases, Beijing, China.
FAU - Li, Xiang-Yu
AU  - Li XY
AD  - Department of Orthopedics, Xuanwu Hospital, Capital Medical University, Beijing, 
      China.
AD  - National Clinical Research Center for Geriatric Diseases, Beijing, China.
FAU - Kong, Chao
AU  - Kong C
AD  - Department of Orthopedics, Xuanwu Hospital, Capital Medical University, Beijing, 
      China.
AD  - National Clinical Research Center for Geriatric Diseases, Beijing, China.
FAU - Ma, Jin
AU  - Ma J
AD  - Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, 
      China.
FAU - Lu, Shi-Bao
AU  - Lu SB
AD  - Department of Orthopedics, Xuanwu Hospital, Capital Medical University, Beijing, 
      China.
AD  - National Clinical Research Center for Geriatric Diseases, Beijing, China.
LA  - eng
PT  - Journal Article
DEP - 20240123
PL  - United States
TA  - Spine (Phila Pa 1976)
JT  - Spine
JID - 7610646
RN  - 0 (Albumins)
SB  - IM
MH  - Humans
MH  - Aged
MH  - *Nutritional Status
MH  - Nutrition Assessment
MH  - Retrospective Studies
MH  - *Malnutrition/diagnosis
MH  - Albumins
MH  - Postoperative Complications/epidemiology
PMC - PMC10962431
COIS- The authors report no conflicts of interest.
EDAT- 2024/01/23 12:42
MHDA- 2024/03/28 06:45
PMCR- 2024/03/25
CRDT- 2024/01/23 08:23
PHST- 2023/10/02 00:00 [received]
PHST- 2024/01/08 00:00 [accepted]
PHST- 2024/03/28 06:45 [medline]
PHST- 2024/01/23 12:42 [pubmed]
PHST- 2024/01/23 08:23 [entrez]
PHST- 2024/03/25 00:00 [pmc-release]
AID - 00007632-990000000-00563 [pii]
AID - SPINE166814 [pii]
AID - 10.1097/BRS.0000000000004933 [doi]
PST - ppublish
SO  - Spine (Phila Pa 1976). 2024 Apr 15;49(8):536-546. doi: 
      10.1097/BRS.0000000000004933. Epub 2024 Jan 23.