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Preoperative prognostic nutritional index as a predictive factor for medical complication after cervical posterior decompression surgery: A multicenter study.
- Source :
-
Journal of orthopaedic surgery (Hong Kong) [J Orthop Surg (Hong Kong)] 2021 Jan-Apr; Vol. 29 (1), pp. 23094990211006869. - Publication Year :
- 2021
-
Abstract
- Study Design: Retrospective longitudinal cohort study.<br />Objective: To investigate postoperative medical complications in patients with malnutrition after cervical posterior surgery.<br />Methods: A total of 256 patients were participated and divided into PNI < 50 group (group L) or PNI ≥ 50 (group H). Patient data, preoperative laboratory data, surgical data, hospitalization data, JOA score, complication data were measured.<br />Results: Group L and group H were 127 and 129 patients, each PNI was L: 44.8 ± 4.3, H: 54.6 ± 4.0, P < 0.01. There was significant difference in mean age (L: 72.2 years vs H: 64.8 years, P < 0.01), BMI (23.1 vs 24.7, P < 0.01), serum albumin (L: 3.9 ± 0.4 g/dl vs H: 4.4 ± 0.3 g/dl, P < 0.01), total lymphocyte count (L: 1.3 ± 0.5 10 <superscript>3</superscript> /µL vs H: 2.1 ± 0.7 10 <superscript>3</superscript> /μL, P < 0.01), hospital stay (L: 25.0 days vs H: 18.8 days, P < 0.05), discharge to home (87.5% vs 57.5%, P < 0.01), delirium (L: 15.9% vs H: 3.9%, P < 0.01), medical complications (L: 25.2% vs H: 7.0%, P < 0.01), pre- and post- operative JOA score (L: 11.3 ± 2.8 vs H: 12.4 ± 2.6, P < 0.01; L: 13.3 ± 3.0 vs H: 14.1 ± 2.4, P = 0.02). Multiple logistic regression analysis showed that significant risk factors for medical complications were PNI<50 (P = 0.024, odds ratio [OR] 2.746, 95% confidence interval [CI] 1.143-6.600) and age (P = 0.005, odds ratio [OR] 1.064, 95% confidence interval [CI] 1.020-1.111).<br />Conclusion: Medical complications are significantly higher in patients with PNI < 50 and higher age. The results showed that PNI is a good indicator for perioperative medical complications in cervical posterior surgery. Improvement of preoperative nutritional status is important to avoid medical complications.<br />Level of Evidence: 3.
- Subjects :
- Aged
Aged, 80 and over
Cohort Studies
Decompression, Surgical methods
Female
Health Status Indicators
Humans
Laminectomy adverse effects
Laminectomy methods
Laminoplasty adverse effects
Laminoplasty methods
Longitudinal Studies
Male
Malnutrition complications
Malnutrition surgery
Middle Aged
Neck surgery
Nutrition Assessment
Perioperative Period
Postoperative Complications etiology
Prognosis
Retrospective Studies
Risk Factors
Cervical Vertebrae surgery
Decompression, Surgical adverse effects
Malnutrition diagnosis
Nutritional Status
Postoperative Complications diagnosis
Subjects
Details
- Language :
- English
- ISSN :
- 2309-4990
- Volume :
- 29
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Journal of orthopaedic surgery (Hong Kong)
- Publication Type :
- Academic Journal
- Accession number :
- 33832377
- Full Text :
- https://doi.org/10.1177/23094990211006869