医学
白蛋白
腰椎
队列
外科
血清白蛋白
混淆
内科学
作者
Ankit I. Mehta,A Rademacher,Matthew Easton,Yaqoub 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 M. Soo,Doris Tong,Victor Chang
出处
期刊:Journal of neurosurgery
[Journal of Neurosurgery Publishing Group]
日期:2024-09-01
卷期号:: 1-11
标识
DOI:10.3171/2024.5.spine24113
摘要
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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