Preoperative hypoalbuminemia and dialysis increase morbidity/mortality after spine surgery for primary pyogenic spinal infections (ACS-NSQIP Study)

Author:

Camino-Willhuber Gaston1,Franklin Austin2,Rosecrance Katherine2,Oyadomari Sarah2,Chan Justin3,Holc Fernando1,Hashmi Sohaib3,Oh Michael4,Bhatia Nitin3,Emmerich Juan5,Lee Yu-Po3

Affiliation:

1. Department of Orthopedics, Institute of Orthopedics “Carlos E. Ottolenghi,” Hospital Italiano de Buenos Aires, Buenos Aires, Argentina,

2. School of Medicine, University of California Irvine,

3. Department of Orthopaedics, University of California Irvine, Orange, California, United States,

4. Department of Neurosurgery, University of California Irvine, Orange, California, United States,

5. Department of Neurological Surgery, Children’s Hospital La Plata, La Plata, Argentina.

Abstract

Background: We analyzed the role of hypoalbuminemia, dialysis, and other risk factors that increase morbidity/ mortality following surgery for primary pyogenic spinal infections (PSIs). The American College of Surgeons’ National Surgical Quality Improvement Program (ACS-NSQIP) that included 627 patients was utilized as our database. Methods: Primary spinal surgery for spondylodiscitis was evaluated in a ACS-NSQIP database involving 627 patients between 2010 and 2019. Outcome assessment included evaluation of 30-day postoperative morbidity, and mortality rates. Results: Within 30 postoperative days, complications occurred in 14.6% (92/627) of patients; 59 (9.4%) required readmission, and 39 (6.2%) required additional surgery. The most common complications were: wound infections, pneumonia, septic shock, and death (1.8%). Hypoalbuminemia (i.e., significantly associated with unplanned readmission and reoperation), and dialysis were the two major risk factors contributing to increased perioperative morbidity and mortality. Conclusion: Among 627 ACS-NSQIP patients undergoing primary surgery for PSIs, hypoalbuminemia and dialysis were associated with higher risks of major perioperative morbidity (i.e., within 30 postoperative days – mostly readmissions and reoperations) and mortality.

Publisher

Scientific Scholar

Subject

Neurology (clinical),Surgery

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