Association of Frailty and Preoperative Hypoalbuminemia with the Risk of Complications, Readmission, and Mortality After Spine Surgery

被引：11

作者：

Camino-Willhuber, Gaston ^{[1
]}

Tani, Soji ^{[1
,2
]}

Schonnagel, Lukas ^{[1
]}

Caffard, Thomas ^{[1
]}

Haffer, Henryk ^{[3
,4
,5
]}

Chiapparelli, Erika ^{[1
]}

Sarin, Michele ^{[1
]}

Shue, Jennifer ^{[1
]}

Soffin, Ellen M. ^{[6
]}

Zelenty, William D. ^{[1
]}

Sokunbi, Gbolabo ^{[1
]}

Lebl, Darren R. ^{[1
]}

Cammisa, Frank P. ^{[1
]}

Girardi, Federico P. ^{[1
]}

Hughes, Alexander P. ^{[1
]}

Sama, Andrew A. ^{[1
]}

机构：

[1] Hosp Special Surg, Spine Care Inst, Orthopaed Surg, New York, NY 10021 USA

[2] Showa Univ Hosp, Sch Med, Dept Orthopaed Surg, Tokyo, Japan

[3] Charite Univ Med Berlin, Ctr Musculoskeletal Surg, Berlin, Germany

[4] Free Univ Berlin, Berlin, Germany

[5] Humboldt Univ, Berlin, Germany

[6] Hosp Special Surg, Dept Anesthesiol Crit Care & Pain Management, New York, NY USA

来源：

WORLD NEUROSURGERY | 2023年 / 174卷

关键词：

Complications; Frailty status; Hypoalbuminemia; Mortality; 30-DAY POSTOPERATIVE COMPLICATIONS; SERUM-ALBUMIN; INDEX; PREDICTOR; NUTRITION; FUSION;

D O I：

10.1016/j.wneu.2023.03.095

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

BACKGROUND: Frailty status and hypoalbuminemia have been associated with higher rates of complications after spine surgery. However, the combination of both conditions has not been fully analyzed. The objective of this study was to assess the effect of frailty and hypo-albuminemia on the risk of complications after spine surgery. -METHODS: The American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) data-base from 2009 to 2019 was used. Frailty status was calculated using the modified 5-item frailty index (mFI-5). Patients were classified into nonfrail (mFI = 0), pre-frail (mFI = 1), and frail (mFI & DDAG;2) groups and also based on albumin levels into normal (& DDAG;3.5 g/dL) and hypo-albuminemia groups (<3.5 g/dL). The latter group was also subclassified into mild and severe hypoalbuminemia groups. Multivariable analysis was used. A Spearman r correlation between albuminemia and mFI-5 was also performed. -RESULTS: A total of 69,519 patients (36,705 men [52.8%] and 32,814 women [47.2%]) with a mean age of 61.0 & PLUSMN; 13.2 years were included. Patients were classified as nonfrail (n = 24,897), pre-frail (n = 28,897), and frail groups (n = 15,725). Hypoalbuminemia was significantly higher in the frail group (11.4%) compared with the nonfrail group (4.3%). An inverse correlation was observed between albumin levels and frailty status (r = -0.139; P < 0.0001). Frail patients with severe hypoalbuminemia had significantly higher risk of complications (odds ratio [OR], 5.0), reoper-ation (OR, 3.3), readmission (OR, 3.1), and mortality (OR, 31.8) compared with patients without hypoalbuminemia. -CONCLUSIONS: The combination of frailty and hypo-albuminemia significantly increases the risk of complica-tions after spine surgery. The prevalence of hypoalbuminemia in the frailty group was significantly higher than in nonfrail patients (11.4% vs. 4.3%). Both conditions should be evaluated preoperatively.

引用

页码：E152 / E158

页数：7

共 31 条

[31] The 5-Item Modified Frailty Index Is Predictive of Severe Adverse Events in Patients Undergoing Surgery for Adult Spinal Deformity [J].

Yagi, Mitsuru ;

Michikawa, Takehiro ;

Hosogane, Naobumi ;

Fujita, Nobuyuki ;

Okada, Eijiro ;

Suzuki, Satoshi ;

Tsuji, Osahiko ;

Nagoshi, Narihito ;

Asazuma, Takashi ;

Tsuji, Takashi ;

Nakamura, Masaya ;

Matsumoto, Morio ;

Watanabe, Kota .

SPINE, 2019, 44 (18) :E1083-E1091

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