Serum albumin levels predict which patients are at increased risk for complications following surgical management of acute osteoporotic vertebral compression fractures

Gupta, Anmol; Upadhyaya, Shivam; Cha, Thomas; Schwab, Joseph H.; Bono, Christopher M.; Hershman, Stuart H.

doi:10.1016/j.spinee.2019.06.023

Cited by 25 publications

(21 citation statements)

References 29 publications

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“…In a previous study, we showed that preoperative serum albumin levels can be useful to help predict postsurgical outcome, as severely malnourished patients with OVCF exhibited a mortality odds ratio of nearly 3.0 relative to patients with OVCF whose serum albumin levels were in the normal range. 7 Similarly, other studies have shown that the Charlson comorbidity index, which attempts to predict the risk of death within 1 year of hospitalization based on comorbid conditions, 19,20 is also valuable for assessing a patient's risk-profile. 7,[21][22][23] Additionally, it was found that diminishing preoperative functional status is statistically correlated with a higher rate of adverse outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…7 Similarly, other studies have shown that the Charlson comorbidity index, which attempts to predict the risk of death within 1 year of hospitalization based on comorbid conditions, 19,20 is also valuable for assessing a patient's risk-profile. 7,[21][22][23] Additionally, it was found that diminishing preoperative functional status is statistically correlated with a higher rate of adverse outcomes. Our data also shows that male gender was more prevalent in the <70-year age group and was correlated with an increased likelihood of mortality.…”

Section: Discussionmentioning

confidence: 99%

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Age Is Just a Number: Patient Age Does Not Affect Outcome Following Surgery for Osteoporotic Vertebral Compression Fractures

Gupta

Cha

Schwab

et al. 2020

Global Spine Journal

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Study Design: Retrospective study. Objective: Multiple studies have shown that osteoporotic patients are at an increased risk for medical and surgical complications, making optimal management of these patients challenging. The purpose of this study was to determine the relationship between patient age and the likelihood of surgical complications, mortality, and 30-day readmission rates following surgery for osteoporotic vertebral compression fractures (OVCFs). Methods: A retrospective analysis of the American College of Surgeons National Surgery Quality Improvement Project (ACS-NSQIP) database from 2007 to 2014 identified 1979 patients who met inclusion criteria. A multivariate logistic regression analysis was conducted to calculate odds ratios (OR), with corresponding P values and 95% confidence intervals, of the relationship between age (treated as a continuous variable) and perioperative mortality, surgical complications, and 30-day readmission rates. Results: Younger patients were statistically more likely to endure a minor (OR = 0.98; P = .002) or major complication (OR = 0.97; P = .009). The older a patient was, on the other hand, the higher the likelihood that patient would be readmitted within 30 days of surgery (OR =1.02; P = .004). Mortality within the 30-day perioperative period was not statistically correlated with age. Conclusions: The impact of age on adverse outcomes following surgery for OVCF is mixed. While younger patients are more likely to endure complications, older patients are more likely to be readmitted within 30 days following surgery. Patient age showed no correlation with mortality rates. In the setting of surgical treatment for an OVCF, a patient’s age can help determine the risk of complications and the rate of readmission following intervention.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Age Is Just a Number: Patient Age Does Not Affect Outcome Following Surgery for Osteoporotic Vertebral Compression Fractures

Gupta

Cha

Schwab

et al. 2020

Global Spine Journal

Self Cite

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“…Preoperative albumin bears strong potential as a practical metric to assess a patient's overall health [24]. Recent studies even show that low ALB rather re ects a state of persistent in ammation [25].…”

Section: Discussionmentioning

confidence: 99%

A Nomogram to Predict Postoperative Complications in Elderly with Total Hip Replacement

Tan

et al. 2020

Preprint

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Background: By analyzing the risk factors of postoperative complications in elderly patients with hip replacement, We aimed to develop a nomogram model based on preoperative and intraoperative variables and verified the sensitivity and specificity for risk stratification of postoperative complications in elderly with total hip replacement patients.Methods: A total of 414 elderly patients who underwent surgical treatment for total hip replacement hospitalized at the Affiliated Hospital of Guangdong Medical University from March 1, 2017 to August 31, 2019 were included into this study. Univariate and multivariate logistic regression were conducted to identify independent risk factors of postoperative complication in the 414 patients. A nomogram was developed by R software and validated to predict the risk of postoperative complications.Results: Multivariate logistic regression analysis revealed that age (OR=1.05, 95%CI: 1.00-1.09) , renal failure(OR=0.90, 95% CI: 0.83～0.97) , Type2 diabetes (OR=1.05, 95% CI: 1.00～1.09) , ALB (OR=0.91, 95% CI: 0.83～0.99) were independent risk factors of postoperative complication in elderly patients with hip replacement (P＜0.05) . For validation of the nomogram, ROC curve revealed that the model predicting postoperative complication in elderly patients with hip replacement was the area under the curve of 0.8254(95% CI: 0.78～0.87) , the slope of the calibration plot was close to 1 and the model passed Hosmer-Lemeshow goodness of fit test (x2 = 10.16, P=0.4264), calibration in R Emax=0.176, Eavg=0.027, which all demonstrated that the model was of good accuracy. Conclusion: The nomogram predicting postoperative complications in patients with total hip replacement constructed based on age, type 2 diabetes, renal failure and ALB is of good discrimination and accuracy, which was of clinical significance.

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“…[21,22] Additionally, a recent study indicated that serum albumin levels predict which patients are at increased risk for minor or major complications, or mortality, following surgical management of acute osteoporotic vertebral compression fractures. [23] We presumed that patients with long-term post-injury OVF may be at increased risk of malnutrition due to ongoing pain compared to acute fractures. Serum albumin is a wellknown and important marker of preoperative nutritional status.…”

Section: Discussionmentioning

confidence: 99%

Factors affecting postoperative survival of patients with insufficient union following osteoporotic vertebral fractures and impact of preoperative serum albumin on mortality

Ohba

Yokomi

Koy

et al. 2020

Preprint

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Abstract Background: Numerous comparative studies of surgical procedures have focused on clinical and radiographical outcomes, as well as the effect of bone fragility on the outcome of spinal surgery; however, insights concerning a long-term risk of mortality or morbidity have been limited. Additionally, the effect of surgical therapy on survival after vertebral compression fractures remains controversial. Our aim was to evaluate the preoperative factors that affected the long-term survival of patients who underwent spinal surgery for an insufficient union following osteoporotic vertebral fractures (OVF) and to determine long-term mortality. Methods: We retrospectively reviewed the cases of 105 consecutive patients who underwent spinal surgery for OVF. Mortality was estimated using the Kaplan-Meier method and a log-rank test. The preoperative backgrounds of patients were analyzed to determine which risk factors led to death among the OVF cases. Kaplan-Meier curves were used to estimate survival based on preoperative albumin levels of £ 3.5 g/dL (hypoalbuminemia) versus > 3.5 mg/dL. Results: The mean follow-up time for survival was 4.1 ±0.8 years. Two years after surgery, 15% of patients with OVF had died. The ratio of male-to-female was significantly higher for patients with OVF who died than for those who were still alive. No significant difference in mortality was observed among surgical procedures for OVF. Multivariate analysis revealed that only serum albumin £3.5 g/dL was a significant risk factor for long-term postoperative mortality of patients with OVF. Conclusions: Preoperative hypoalbuminemia was associated with long-term postoperative mortality following surgery for OVF.

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Serum albumin levels predict which patients are at increased risk for complications following surgical management of acute osteoporotic vertebral compression fractures

Cited by 25 publications

References 29 publications

Age Is Just a Number: Patient Age Does Not Affect Outcome Following Surgery for Osteoporotic Vertebral Compression Fractures

Age Is Just a Number: Patient Age Does Not Affect Outcome Following Surgery for Osteoporotic Vertebral Compression Fractures

A Nomogram to Predict Postoperative Complications in Elderly with Total Hip Replacement

Factors affecting postoperative survival of patients with insufficient union following osteoporotic vertebral fractures and impact of preoperative serum albumin on mortality

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