PMID- 38541767 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20240330 IS - 2077-0383 (Print) IS - 2077-0383 (Electronic) IS - 2077-0383 (Linking) VI - 13 IP - 6 DP - 2024 Mar 7 TI - Association of Malnutrition with Surgical and Hospital Outcomes after Spine Surgery for Spinal Metastases: A National Surgical Quality Improvement Program Study of 1613 Patients. LID - 10.3390/jcm13061542 [doi] LID - 1542 AB - Background: Malnutrition is a common condition that may exacerbate many medical and surgical pathologies. However, few have studied the impact of malnutrition on surgical outcomes for patients undergoing surgery for metastatic disease of the spine. This study aims to evaluate the impact of malnutrition on perioperative complications and healthcare resource utilization following surgical treatment of spinal metastases. Methods: We conducted a retrospective cohort study using the 2011-2019 American College of Surgeons National Surgical Quality Improvement Program database. Adult patients with spinal metastases who underwent laminectomy, corpectomy, or posterior fusion for extradural spinal metastases were identified using the CPT, ICD-9-CM, and ICD-10-CM codes. The study population was divided into two cohorts: Nourished (preoperative serum albumin values >/= 3.5 g/dL) and Malnourished (preoperative serum albumin values < 3.5 g/dL). We assessed patient demographics, comorbidities, intraoperative variables, postoperative adverse events (AEs), hospital LOS, discharge disposition, readmission, and reoperation. Multivariate logistic regression analyses were performed to identify the factors associated with a prolonged length of stay (LOS), AEs, non-routine discharge (NRD), and unplanned readmission. Results: Of the 1613 patients identified, 26.0% were Malnourished. Compared to Nourished patients, Malnourished patients were significantly more likely to be African American and have a lower BMI, but the age and sex were similar between the cohorts. The baseline comorbidity burden was significantly higher in the Malnourished cohort compared to the Nourished cohort. Compared to Nourished patients, Malnourished patients experienced significantly higher rates of one or more AEs (Nourished: 19.8% vs. Malnourished: 27.6%, p = 0.004) and serious AEs (Nourished: 15.2% vs. Malnourished: 22.6%, p < 0.001). Upon multivariate regression analysis, malnutrition was found to be an independent and associated with an extended LOS [aRR: 3.49, CI (1.97, 5.02), p < 0.001], NRD [saturated aOR: 1.76, CI (1.34, 2.32), p < 0.001], and unplanned readmission [saturated aOR: 1.42, CI (1.04, 1.95), p = 0.028]. Conclusions: Our study suggests that malnutrition increases the risk of postoperative complication, prolonged hospitalizations, non-routine discharges, and unplanned hospital readmissions. Further studies are necessary to identify the protocols that pre- and postoperatively optimize malnourished patients undergoing spinal surgery for metastatic spinal disease. FAU - Elsamadicy, Aladine A AU - Elsamadicy AA AD - Department of Neurosurgery, Yale University School of Medicine, 333 Cedar Street, New Haven, CT 06510, USA. FAU - Havlik, John AU - Havlik J AD - Department of Neurosurgery, Yale University School of Medicine, 333 Cedar Street, New Haven, CT 06510, USA. FAU - Reeves, Benjamin C AU - Reeves BC AD - Department of Neurosurgery, Yale University School of Medicine, 333 Cedar Street, New Haven, CT 06510, USA. FAU - Sherman, Josiah J Z AU - Sherman JJZ AD - Department of Neurosurgery, Yale University School of Medicine, 333 Cedar Street, New Haven, CT 06510, USA. FAU - Craft, Samuel AU - Craft S AD - Department of Neurosurgery, Yale University School of Medicine, 333 Cedar Street, New Haven, CT 06510, USA. FAU - Serrato, Paul AU - Serrato P AUID- ORCID: 0000-0003-2550-3221 AD - Department of Neurosurgery, Yale University School of Medicine, 333 Cedar Street, New Haven, CT 06510, USA. FAU - Sayeed, Sumaiya AU - Sayeed S AD - Department of Neurosurgery, Yale University School of Medicine, 333 Cedar Street, New Haven, CT 06510, USA. FAU - Koo, Andrew B AU - Koo AB AD - Department of Neurosurgery, Yale University School of Medicine, 333 Cedar Street, New Haven, CT 06510, USA. FAU - Khalid, Syed I AU - Khalid SI AD - Department of Neurosurgery, University of Illinois at Chicago, Chicago, IL 60612, USA. FAU - Lo, Sheng-Fu Larry AU - Lo SL AUID- ORCID: 0000-0001-7262-2544 AD - Department of Neurosurgery, Zucker School of Medicine at Hofstra, Long Island Jewish Medical Center, North Shore University Hospital, Northwell Health, Manhasset, NY 11030, USA. FAU - Shin, John H AU - Shin JH AD - Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA. FAU - Mendel, Ehud AU - Mendel E AUID- ORCID: 0009-0007-7363-8039 AD - Department of Neurosurgery, Yale University School of Medicine, 333 Cedar Street, New Haven, CT 06510, USA. FAU - Sciubba, Daniel M AU - Sciubba DM AD - Department of Neurosurgery, Zucker School of Medicine at Hofstra, Long Island Jewish Medical Center, North Shore University Hospital, Northwell Health, Manhasset, NY 11030, USA. LA - eng PT - Journal Article DEP - 20240307 PL - Switzerland TA - J Clin Med JT - Journal of clinical medicine JID - 101606588 PMC - PMC10971134 OTO - NOTNLM OT - NSQIP OT - complication OT - length of stay OT - malnutrition OT - spinal metastasis COIS- The authors declare no conflicts of interest. EDAT- 2024/03/28 06:45 MHDA- 2024/03/28 06:46 PMCR- 2024/03/07 CRDT- 2024/03/28 01:15 PHST- 2023/11/21 00:00 [received] PHST- 2024/02/23 00:00 [revised] PHST- 2024/03/04 00:00 [accepted] PHST- 2024/03/28 06:46 [medline] PHST- 2024/03/28 06:45 [pubmed] PHST- 2024/03/28 01:15 [entrez] PHST- 2024/03/07 00:00 [pmc-release] AID - jcm13061542 [pii] AID - jcm-13-01542 [pii] AID - 10.3390/jcm13061542 [doi] PST - epublish SO - J Clin Med. 2024 Mar 7;13(6):1542. doi: 10.3390/jcm13061542.