Lin Charles C, Qureshi Ibraheem, Anil Utkarsh, Lin Lawrence J, Leucht Philipp
New York University Langone Orthopedic Hospital, New York, USA.
New York Institute of Technology College of Osteopathic Medicine, Old Westbury, USA.
Eur J Orthop Surg Traumatol. 2025 Feb 25;35(1):76. doi: 10.1007/s00590-025-04183-x.
The purpose of this study was to determine the association of hypoalbuminemia with adverse outcomes in patients undergoing surgical repair of nonunions or malunions of upper and lower extremity long bones.
DESIGN: Retrospective.
Hospitals participating in American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) from 2005 to 2019.
Patients in the ACS-NSQIP database with upper extremity and lower extremity fractures who underwent nonunion or malunion repairs and had preoperative serum albumin levels. Outcome Measures and Comparisons: Demographic variables, comorbidities and postoperative complications were collected and compared using t tests and chi squared tests. Multivariate linear regression models were used to assess complications, adjusting for variables such as age, sex, BMI, hospital length of stay, and operation time.
Univariate analysis of 1640 total patients (338 [20.6%] with hypoalbuminemia and 1302 [79.4%] with normal albumin) showed patients with hypoalbuminemia had significantly increased 30-day mortality rates, increased lengths of stay, and returns to the operating room. Multivariate analysis showed patients with hypoalbuminemia had significantly greater odds for any complication (OR: 2.62; 95% CI [1.77, 3.84]; p < 0.001), surgical site infections (OR: 2.62; 95% CI [1.34, 4.99]; p = 0.004) and transfusions (OR: 2.77; 95% CI: [1.62, 4.69]; p < 0.001) compared to the normal albumin group.
There was a significant difference in 30-day postoperative complications between patients with normal albumin levels and those who were hypoalbuminemic after surgical repairs of nonunions or malunions. Albumin level is a risk factor that should be monitored and counseled upon prior to surgical intervention for nonunion or malunion correction.
Level III Retrospective Comparative Study.
本研究旨在确定低白蛋白血症与接受上肢和下肢长骨骨不连或骨畸形愈合手术修复患者不良结局之间的关联。
设计：回顾性研究。
2005年至2019年参与美国外科医师学会国家外科质量改进计划（ACS-NSQIP）的医院。
ACS-NSQIP数据库中接受骨不连或骨畸形愈合修复且术前有血清白蛋白水平的上肢和下肢骨折患者。结局指标及比较：收集人口统计学变量、合并症和术后并发症，并使用t检验和卡方检验进行比较。采用多变量线性回归模型评估并发症，并对年龄、性别、体重指数、住院时间和手术时间等变量进行校正。
对1640例患者进行单因素分析（338例[20.6%]为低白蛋白血症患者，1302例[79.4%]为白蛋白水平正常患者），结果显示低白蛋白血症患者30天死亡率显著增加、住院时间延长且返回手术室的比例增加。多变量分析显示，与白蛋白水平正常组相比，低白蛋白血症患者发生任何并发症（比值比：2.62；95%置信区间[1.77, 3.84]；p＜0.001）、手术部位感染（比值比：2.62；95%置信区间[1.34, 4.99]；p = 0.004）和输血（比值比：2.77；95%置信区间：[1.62, 4.69]；p＜0.001）的几率显著更高。
骨不连或骨畸形愈合手术修复后，白蛋白水平正常的患者与低白蛋白血症患者在术后30天并发症方面存在显著差异。白蛋白水平是一个危险因素，在进行骨不连或骨畸形愈合矫正的手术干预前应进行监测并给予相应建议。
III级回顾性比较研究。
