Preoperative hypoalbuminemia (<3.5 g/dL) was an independent predictor of prolonged length of stay (OR 2.4; 95% CI 1.7-3.5) and unplanned readmission (OR 2.7; 95% CI 1.1-6.3) following elective PLF.
Cohort (n=2,410)
Yes
Does preoperative hypoalbuminemia increase 30-day perioperative complications, prolonged length of stay, and readmission in adults undergoing elective posterior lumbar fusion?
Preoperative hypoalbuminemia is an independent predictor of prolonged length of stay and unplanned readmission following elective posterior lumbar fusion, highlighting the importance of nutritional screening.
Effect estimate: OR 2.4 (95% CI 1.7-3.5)
p-value: p=<0.001
Study Design: Retrospective study. Objective: To determine the rates of early postoperative mortality and morbidity in adults with hypoalbuminemia undergoing elective posterior lumbar fusion (PLF). Methods: The American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) was examined from 2005 to 2012. Current Procedural Terminology (CPT) codes were used to query the database for adults (≥18 years) who underwent PLF and/or posterior/transforaminal lumbar interbody fusion (PLIF/TLIF). Patients were divided into those with normal albumin concentration (≥3.5g/dL) and those with hypoalbuminemia (5 days ( P < .001). However, hypoalbuminemia was not significantly associated with any specific perioperative complication. On multivariate analysis, preoperative hypoalbuminemia was found to be an independent predictor of prolonged LOS (OR 2.4, 95% CI 1.7-3.5; P < .001) and unplanned readmission (OR 2.7, 95% CI 1.1-6.3; P = .023). Conclusion: Hypoalbuminemia was found to be an important predictor of patient outcomes in this population. This study suggests that clinicians should consider nutritional screening and optimization as part of the preoperative risk assessment algorithm. Level of Evidence: III
Phan et al. (Wed,) conducted a cohort in Elective posterior lumbar fusion (n=2,410). Hypoalbuminemia (<3.5 g/dL) vs. Normal albumin concentration (≥3.5 g/dL) was evaluated on Prolonged length of stay (>5 days) (OR 2.4, 95% CI 1.7-3.5, p=<0.001). Preoperative hypoalbuminemia (<3.5 g/dL) was an independent predictor of prolonged length of stay (OR 2.4; 95% CI 1.7-3.5) and unplanned readmission (OR 2.7; 95% CI 1.1-6.3) following elective PLF.