Congress of Neurological Surgeons Systematic Review and Evidence-Based Guidelines for Perioperative Spine: Preoperative Nutritional Assessment

Bisson, Erica F.; Dimar, John R.; Hoh, Daniel J.; Mohamed, Basma; Mummaneni, Praveen V.; Wang, Marjorie C.; Dhall, Sanjay S.

doi:10.1093/neuros/nyab318

Cited by 17 publications

(14 citation statements)

References 37 publications

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“…Hypoalbuminemia has commonly been used as a marker of nutritional status correlated with delayed wound healing, SSI, readmission, sepsis, and postoperative mortality across several surgical subspecialties. 16,20,[31][32][33] In orthopedics, some surgeons draw serum albumin as a routine preoperative laboratory test and postpone surgery until albumin reaches the normal range with the aid of a nutritionist. 16 Although the association between malnutrition and low albumin level has been challenged, in 2018, Khanna et al recommended albumin as a simple measure of nutritional status that is sensitive to both small nutritional deficiencies and acute changes in nutrition.…”

Section: Discussionmentioning

confidence: 99%

“Compound Effect of Hypoalbuminemia and Obesity on Complications after Autologous Breast Reconstruction”

Chiang

Finnan²,

Skolnick³

et al. 2023

Plastic &Amp; Reconstructive Surgery

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besity has been consistently associated with postoperative complications in autologous breast reconstruction, as in many other surgical fields, because of impaired wound healing and heavier flaps that may make procedures more complex and lengthy. [1][2][3][4][5] With the rising prevalence of obesity in the United States, there has been a growing interest in the association between increased body mass index (BMI) and poor nutrition. 6 Obesity is often associated with decreased muscle mass, protein malnutrition, and other micronutrient deficiencies, a condition termed sarcopenic obesity. 1,7,8 Background: Obesity is among the risk factors identified that impair postoperative wound healing. Recently, malnutrition and sarcopenia have also been found to correlate with poor surgical outcomes; however, the effect of malnutrition in the setting of obesity is understudied, particularly in reconstructive surgery. The authors examine the American College of Surgeons National Surgery Quality Improvement Program database to determine the impact of obesity plus hypoalbuminemia on complications after autologous breast reconstruction. Methods: Autologous breast reconstruction procedures (pedicled and free flaps) were collected from the 2009 to 2019 National Surgery Quality Improvement Program databases by CPT codes (n = 23,690). Patients without height, weight, or preoperative serum albumin data (n = 12,825) were excluded. Demographics and postoperative outcomes were compared in patients with obesity (body mass index >30 kg/m 2 ) and malnutrition (albumin <3.5 g/dL). Propensity scorematched cohorts with and without malnutrition were also compared. Results: A total of 10,865 procedures were included in analysis; 4565 involved patients with obesity (42%). Obesity was associated with increased length of stay, reoperations, wound complications, and medical complications (all P < 0.001). Among patients with obesity, 198 had malnutrition (4.3%). The combination of obesity and malnutrition was associated with a higher rate of wound complications (16%) over obesity alone (9.2%) or malnutrition alone (9.2%, both P < 0.05). This difference is recapitulated in propensity score-matched analysis. Conclusion: Hypoalbuminemia, a marker of malnutrition, is underappreciated in obese patients and is associated with worse surgical outcomes after autologous breast reconstruction compared with obesity alone.

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Section: Discussionmentioning

confidence: 99%

“Compound Effect of Hypoalbuminemia and Obesity on Complications after Autologous Breast Reconstruction”

Chiang

Finnan²,

Skolnick³

et al. 2023

Plastic &Amp; Reconstructive Surgery

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“…It should be noted that prolonged fasting, for example, less than 25% calorie needs continuously over a period of more than one day should be avoided immediately prior to or following surgery to avoid malnourishment in at-risk patients including: the elderly, those already malnourished, bariatric patients, and individuals diagnosed with cancer as there is a catabolic response induced by the surgical trauma itself [193,194]. Decreased energy consumption during hospitalization is associated with increased length of hospital stays, rates of readmission, and mortality, especially in frail and malnourished patients [195,196]. Traditional preoperative fasting guidelines that keep patients fasting from midnight before surgery may be outdated [197,198].…”

Section: Considerations and Contraindicationsmentioning

confidence: 99%

Intermittent Fasting: Potential Utility in the Treatment of Chronic Pain across the Clinical Spectrum

et al. 2022

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Dietary behavior can have a consequential and wide-ranging influence on human health. Intermittent fasting, which involves intermittent restriction in energy intake, has been shown to have beneficial cellular, physiological, and system-wide effects in animal and human studies. Despite the potential utility in preventing, slowing, and reversing disease processes, the clinical application of intermittent fasting remains limited. The health benefits associated with the simple implementation of a 12 to 16 h fast suggest a promising role in the treatment of chronic pain. A literature review was completed to characterize the physiologic benefits of intermittent fasting and to relate the evidence to the mechanisms underlying chronic pain. Research on different fasting regimens is outlined and an overview of research demonstrating the benefits of intermittent fasting across diverse health conditions is provided. Data on the physiologic effects of intermittent fasting are summarized. The physiology of different pain states is reviewed and the possible implications for intermittent fasting in the treatment of chronic pain through non-invasive management, prehabilitation, and rehabilitation following injury and invasive procedures are presented. Evidence indicates the potential utility of intermittent fasting in the comprehensive management of chronic pain and warrants further investigation.

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“…Immune function in patients with diabetes and insulin resistance is also lower than that of healthy people, and in an environment of high sugar, high permeability can increase local exudation and promote engraftment, further growth, and reproduction of local bacteria, and can even cause cracking of the incision (33). Systemic microvascular lesions also result from high blood sugar, which further reduces immune function and weakens the chemotaxis ability of white blood cells, increasing the risk of bacteria and other microorganisms invading the surgical incision site (34). As a traumatic procedure, lung transplantation can also promote systemic stress response in the body, aggravating the degree of insulin resistance and further increasing the risk of incision infection (35).…”

Section: Diabetesmentioning

confidence: 99%

Risk factors of wound infection after lung transplantation: a narrative review

Qian¹,

Sun²,

Xie³

2022

J Thorac Dis

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Background and Objective: The incidence of incision infection after lung transplantation is prominently high which affect the prognosis. Summarizing the risk factors related to incision infection after lung transplantation contribute to the control of incision infection by pre-controlling the risk factors. The objective is to summarize risk factors related to wound infection after lung transplantation.Methods: PubMed was used to research the literature relating to the risk factors to incision infection after lung transplantation through 1990 to 2022. The retrieval strategy were Medical Subject Heading (MeSH) terms combined entry terms. Two researchers conducted the literature retrieval independently. Two researchers independently evaluate the quality of the literature and summarize the indicators.

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Congress of Neurological Surgeons Systematic Review and Evidence-Based Guidelines for Perioperative Spine: Preoperative Nutritional Assessment

Cited by 17 publications

References 37 publications

“Compound Effect of Hypoalbuminemia and Obesity on Complications after Autologous Breast Reconstruction”

“Compound Effect of Hypoalbuminemia and Obesity on Complications after Autologous Breast Reconstruction”

Intermittent Fasting: Potential Utility in the Treatment of Chronic Pain across the Clinical Spectrum

Risk factors of wound infection after lung transplantation: a narrative review

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