Department of Orthopedic Surgery, Shizuoka City Hospital, Shizuoka City, Japan.
Department of Orthopedic Surgery, 12793Hamamatsu University School of Medicine, Hamamatsu, Japan.
J Orthop Surg (Hong Kong). 2021 Jan-Apr;29(1):23094990211006869. doi: 10.1177/23094990211006869.
Retrospective longitudinal cohort study.
To investigate postoperative medical complications in patients with malnutrition after cervical posterior surgery.
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.
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/µL vs H: 2.1 ± 0.7 10/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).
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.
回顾性纵向队列研究。
探讨颈椎后路手术后营养不良患者的术后医疗并发症。
共纳入 256 例患者，分为 PNI<50 组（L 组）或 PNI≥50 组（H 组）。测量患者数据、术前实验室数据、手术数据、住院数据、JOA 评分、并发症数据。
L 组和 H 组分别为 127 例和 129 例，每组 PNI 分别为 L：44.8±4.3，H：54.6±4.0，P<0.01。两组间平均年龄（L：72.2 岁 vs H：64.8 岁，P<0.01）、BMI（23.1 vs 24.7，P<0.01）、血清白蛋白（L：3.9±0.4g/dl vs H：4.4±0.3g/dl，P<0.01）、总淋巴细胞计数（L：1.3±0.5×10/μL vs H：2.1±0.7×10/μL，P<0.01）、住院时间（L：25.0 天 vs H：18.8 天，P<0.05）、出院回家（87.5% vs 57.5%，P<0.01）、谵妄（L：15.9% vs H：3.9%，P<0.01）、医疗并发症（L：25.2% vs H：7.0%，P<0.01）、术前和术后 JOA 评分（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）差异均有统计学意义。多因素 logistic 回归分析显示，医疗并发症的显著危险因素是 PNI<50（P=0.024，比值比[OR]2.746，95%置信区间[CI]1.143-6.600）和年龄（P=0.005，OR 1.064，95%CI 1.020-1.111）。
PNI<50 和年龄较高的患者医疗并发症发生率明显较高。结果表明，PNI 是颈椎后路手术围手术期医疗并发症的一个良好指标。改善术前营养状况对于避免医疗并发症很重要。
3 级。
