Hirase Takashi, Taghlabi Khaled M, Cruz-Garza Jesus G, Faraji Amir H, Marco Rex A W, Saifi Comron
Department of Orthopedic and Sports Medicine, Houston Methodist Hospital, Houston, TX, USA.
Department of Neurosurgery, Houston MethodistHospital, Houston, TX, USA.
Global Spine J. 2024 Sep;14(7):2004-2011. doi: 10.1177/21925682231163814. Epub 2023 Mar 10.
Retrospective review of a prospectively collected national database.
To determine the association between preoperative serum albumin levels and perioperative adverse events (AEs) following vertebral corpectomy and posterior stabilization for metastatic spine disease.
The 2010 to 2019 American College of Surgeons' National Surgical Quality Improvement (ACS-NSQIP) database was used to identify all patients undergoing vertebral corpectomy and posterior stabilization for metastatic spine disease. Receiver operative characteristic (ROC) curve analysis was used to determine preoperative serum albumin cut-off values for predicting perioperative AEs. Low preoperative serum albumin was defined as serum albumin below this cut-off value.
A total of 301 patients were included in the study. ROC curve analysis demonstrated serum albumin < 3.25 g/dL as a cut-off value for predicting perioperative AEs. The low serum albumin group had a higher overall perioperative AEs ( = .041), longer post-operative LOS ( < .001), higher 30-day reoperation rate ( = .014), and a higher in-hospital mortality rate ( = .046). Multivariate analysis demonstrated that low preoperative serum albumin was associated with higher perioperative AEs.
Low serum albumin level is associated with higher perioperative AEs, longer postoperative LOS, and higher rates of 30-day reoperation and in-hospital mortality among patients undergoing vertebral corpectomy and posterior stabilization for metastatic spine disease. Strategies to improve preoperative nutritional status in patients undergoing this procedure may improve these perioperative outcome measures within this surgical population.
III.
对前瞻性收集的全国性数据库进行回顾性分析。
确定转移性脊柱疾病行椎体次全切除及后路内固定术后术前血清白蛋白水平与围手术期不良事件（AE）之间的关联。
使用2010年至2019年美国外科医师学会国家外科质量改进（ACS-NSQIP）数据库，识别所有因转移性脊柱疾病行椎体次全切除及后路内固定术的患者。采用受试者操作特征（ROC）曲线分析来确定预测围手术期AE的术前血清白蛋白临界值。术前血清白蛋白水平低定义为低于该临界值的血清白蛋白水平。
本研究共纳入301例患者。ROC曲线分析显示，血清白蛋白<3.25 g/dL为预测围手术期AE的临界值。低血清白蛋白组围手术期总体AE发生率更高（P = 0.041），术后住院时间更长（P < 0.001），30天再手术率更高（P = 0.014），院内死亡率更高（P = 0.046）。多因素分析表明，术前血清白蛋白水平低与围手术期AE发生率较高相关。
血清白蛋白水平低与转移性脊柱疾病行椎体次全切除及后路内固定术患者围手术期AE发生率较高、术后住院时间较长、30天再手术率和院内死亡率较高相关。改善接受该手术患者术前营养状况的策略可能会改善该手术人群的这些围手术期结局指标。
III级。
