Malnutrition and early postoperative nutritional intake as risk factors for perioperative adverse events after spinal surgery

This is the authors' abstract. We don't add key points for this paper.

time from diagnosis to surgical intervention was 2 days (IQR 1-5).In multivariable Cox regression, longer diagnosis-to-surgery intervals independently predicted prolonged LOS (HR 0.987; 95% CI 0.980-0.994;p<0.001) and slower CRP normalization (HR 0.992; 95% CI 0.985-0.999;p=0.024).Higher baseline CRP and instrumented fusion were also associated with worse outcomes for both endpoints.Sequential testing identified 2 days after SSI diagnosis as a critical threshold, separating early (≤1 day) from delayed (≥2 days) intervention.Surgery within 48 hours was associated with shorter median LOS (39 vs 53 days; adjusted p=0.024) and a trend toward faster CRP normalization (32 vs 49 days; adjusted p=0.056).At 45 days, 58.3% of early-surgery patients were discharged versus 40.4% in the delayed group (p=0.002).CRP normalization at 30 days occurred in 47.7% versus 30.9%, respectively (p=0.002).Conclusion: A 48-hour window after SSI diagnosis appears to be a clinically meaningful threshold: earlier surgery was associated with faster recovery, particularly shorter LOS.These findings support protocol development prioritizing timely surgical intervention to reduce the clinical and economic burden of spinal SSI.