Preoperative Nutritional Status as an Adjunct Predictor of Major Postoperative Complications Following Anterior Cervical Discectomy and Fusion

Fu, Michael C.; Buerba, Rafael A.; Grauer, Jonathan N.

doi:10.1097/bsd.0000000000000181

Cited by 65 publications

(34 citation statements)

References 27 publications

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“…Our study found that obesity was a significant predictor of surgical site complications in orthopaedic trauma patients with high-energy injuries. This is in line with the experience of elective orthopaedic procedures that have reported similar results [10][11][12][13][14][15] . Our data emphasizes the urgent need for proper assessment of malnutrition in orthopaedic trauma patients during the early treatment phase.…”

Section: Discussionsupporting

confidence: 88%

“…Malnutrition as a risk factor for poor outcomes has been well established in the medicine literature [1][2][3][4][5][6] as well as the general surgery literature [7][8][9] . Within the field of orthopaedic surgery, hypoalbuminemia and obesity have been reported as significant risk factor for adverse outcomes in elective procedures, such as arthroplasty and spinal fusions [10][11][12][13][14][15] ,. Data from the literature on malnutrition in orthopaedic trauma patients remains scarce and is mostly limited to studies in elderly patients undergoing hip fracture surgery [16][17][18] .…”

Section: Discussionmentioning

confidence: 99%

“…In addition, the available data on the nutritional status of patients included in this series was limited to albumin levels and BMI. Albumin has been widely established as a standard nutritional serum marker and has been used in numerous studies within the medicine, general surgery, and orthopaedic literature 2,3,5, [9][10][11][12][13][14][15][16] . However, our study does not provide any information on clinical nutrition assessment scales or other nutritional serum markers that may be relevant to orthopaedic patients, such as micronutrients.…”

Section: Discussionmentioning

confidence: 99%

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Hypoalbuminemia and Obesity in Orthopaedic Trauma Patients: Body Mass Index a Significant Predictor of Surgical Site Complications

Egbert

Bouck

Gupte

et al. 2020

Sci Rep

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the purpose of this investigation was to identify the prevalence of hypoalbuminemia and obesity in orthopaedic trauma patients with high-energy injuries and to investigate their impact on the incidence of surgical site complications. Patients 18 years of age and older undergoing intramedullary nail fixation of their femoral shaft fractures at a university-based level-1 trauma centre were assessed. Malnutrition was measured using serum markers (albumin <3.5 g/dL) as well as body mass index (BMI) as a marker of obesity (BMi > 30 kg/m 2 ). The primary outcome measure was surgical wound complications. A total of 249 patients were included in this study. Ninety-eight patients (39.4%) presented with hypoalbuminaemia and 80 patients (32.1%) were obese. The overall incidence of wound complications in our study population was 9.65% (n = 25/259). A logistic regression model showed that non-obese patients (BMI < 30 kg/m 2 ) were at significantly reduced risk for perioperative wound complications (Odds Ratio 0.400 [95% confidence interval 0.168, 0.954], p = 0.039). This study demonstrated a substantial prevalence of hypoalbuminemia and obesity among orthopaedic trauma patients with high-energy injuries. obesity may increase the risk of surgical site complications. Future studies are required to further define malnutrition and its correlation with surgical site complications in orthopaedic trauma patients.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Hypoalbuminemia and Obesity in Orthopaedic Trauma Patients: Body Mass Index a Significant Predictor of Surgical Site Complications

Egbert

Bouck

Gupte

et al. 2020

Sci Rep

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“…Recently, orthopedic surgeons are becoming increasingly aware of the importance of nutritional status prior to elective surgery [9,18,22,27]. To define malnutrition, most surgeons use serum laboratory values such as albumin concentration and total lymphocyte count.…”

Section: Introductionmentioning

confidence: 99%

Hypoalbuminemia is a Better Predictor than Obesity of Complications after Total Knee Arthroplasty: A Propensity Score-Adjusted Observational Analysis

McLawhorn

Padgett

et al. 2017

HSS Journal®: The Musculoskeletal Journal of Hospital for Speci

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Background: Obesity is an established risk factor for complications after total knee arthroplasty (TKA) and is often associated with malnutrition. Questions/Purposes: 1. What is the prevalence of hypoalbuminemia in obese patients undergoing TKA? 2. What is the independent morbidity risk of malnutrition relative to obesity? Methods: TKA cases were identified from the National Surgical Quality Improvement Program from 2005 to 2013. Propensity scores for having preoperative albumin measurements were calculated using demographics, BMI, and modified Charlson Comorbidity Index (CCI). Malnutrition was defined as hypoalbuminemia (<3.5 g/dL). Patients were classified by BMI as follows: non-obese (18.5-29.9), obese I (30-34.9), obese II (35-39.9), or obese III (≥40). Postoperative complications were compared across obesity and nutritional statuses. Multivariable propensity-adjusted logistic regressions were performed to determine associations between malnutrition, obesity, and 30-day outcomes. Results: There were 71,599 cases identified, with 34,800 (48.6%) having albumin measurements. Propensity score adjustment adequately accounted for selection bias, with adjusted p > 0.05 for observable characteristics. Malnutrition prevalence increased with BMI (6.1% in obese III vs. 3.7% in non-obese). With propensity-adjusted multivariable analysis, obese III was the only obesity class associated with any complication, wound complication, and reoperation. Hypoalbuminemia was a stronger and more consistent independent risk factor, for any complication, wound, cardiac, or respiratory complications, and death. Conclusions: Hypoalbuminemia is a more consistent independent predictor of complications after TKA than obesity. Strategies for medical optimization of these conditions should be investigated.

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“…Underweight is a measure of malnutrition, which has been associated with increased risk of infections, numerous medical complications, and death in surgical patients. [16][17][18] The nutritional demands of children in appropriate wound healing and recovery after operative intervention are fundamental in preventing short-term complications. Concurrently, obesity in children has been linked to surgical site infections, thromboembolic events, and decubitus ulcers.…”

Section: Discussionmentioning

confidence: 99%

The Effect of Body Mass Index on Postoperative Morbidity After Orthopaedic Surgery in Children With Cerebral Palsy

Minhas

Chow²,

Otsuka

2016

Journal of Pediatric Orthopaedics

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Preoperative Nutritional Status as an Adjunct Predictor of Major Postoperative Complications Following Anterior Cervical Discectomy and Fusion

Cited by 65 publications

References 27 publications

Hypoalbuminemia and Obesity in Orthopaedic Trauma Patients: Body Mass Index a Significant Predictor of Surgical Site Complications

Hypoalbuminemia and Obesity in Orthopaedic Trauma Patients: Body Mass Index a Significant Predictor of Surgical Site Complications

Hypoalbuminemia is a Better Predictor than Obesity of Complications after Total Knee Arthroplasty: A Propensity Score-Adjusted Observational Analysis

The Effect of Body Mass Index on Postoperative Morbidity After Orthopaedic Surgery in Children With Cerebral Palsy

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