Perioperative hypoalbuminemia is a risk factor for wound complications following posterior lumbar interbody fusion
Abstract Background Although serum albumin levels are increasingly used as an indicator of nutritional status in the clinic, the relationship between perioperative hypoalbuminemia and wound complications after posterior lumbar interbody fusion in the treatment of lumbar degenerative disease remains...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2020-11-01
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| Series: | Journal of Orthopaedic Surgery and Research |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s13018-020-02051-4 |
| _version_ | 1798006101338226688 |
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| author | Zhongyuan He Kai Zhou Ke Tang Zhengxue Quan Shaoyu Liu Bao Su |
| author_facet | Zhongyuan He Kai Zhou Ke Tang Zhengxue Quan Shaoyu Liu Bao Su |
| author_sort | Zhongyuan He |
| collection | DOAJ |
| description | Abstract Background Although serum albumin levels are increasingly used as an indicator of nutritional status in the clinic, the relationship between perioperative hypoalbuminemia and wound complications after posterior lumbar interbody fusion in the treatment of lumbar degenerative disease remains ambiguous. The aim of this study was to evaluate perioperative serum albumin in relation to postoperative wound complications after posterior lumbar interbody fusion in the treatment of single-segment lumbar degenerative disease. Material and methods We reviewed patients who underwent single-segment posterior lumbar interbody fusion surgery from December 2014 to April 2017 in the Department of Orthopedics at the First Affiliated Hospital of Chongqing Medical University. Perioperative (preoperative and early postoperative) serum albumin levels were assessed in all patients and were used to quantify nutritional status. We divided the patients into a surgical wound dehiscence (SWD) group and a normal wound healing group and into a surgical site infection (SSI) group and a non-SSI group. To evaluate the relationship between perioperative serum albumin level and postoperative wound complications, we conducted univariate and multiple logistic regression analyses. Results A total of 554 patients were enrolled in the study. The univariate and multiple logistic regression analysis of these differences showed that preoperative serum albumin < 3.5 g/dl (P = 0.001) and postoperative serum albumin < 3.0 g/dl (P = 0.001) were significantly correlated to SWD. There were also significant differences between the SSI groups in terms of preoperative serum albumin < 3.5 g/dl (P = 0.001) and chronic steroid use (P = 0.003). Additionally, the increased hospitalization costs (P < 0.001) and length of hospitalization (P < 0.001) were statistically significant for patients with perioperative hypoalbuminemia. Conclusions For patients who underwent single-segment posterior lumbar interbody fusion surgery, we need to pay more attention to perioperative hypoalbuminemia and chronic steroid use, which are more likely to be associated with increased wound complications, hospitalization costs, and length of hospitalization after surgery. Adequate assessment and management of these risk factors will help reduce wound complications and hospital stays for surgical patients and will save medical costs. |
| first_indexed | 2024-04-11T12:49:41Z |
| format | Article |
| id | doaj.art-5251914f61d24fa585447a5e60485254 |
| institution | Directory Open Access Journal |
| issn | 1749-799X |
| language | English |
| last_indexed | 2024-04-11T12:49:41Z |
| publishDate | 2020-11-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Orthopaedic Surgery and Research |
| spelling | doaj.art-5251914f61d24fa585447a5e604852542022-12-22T04:23:14ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2020-11-011511810.1186/s13018-020-02051-4Perioperative hypoalbuminemia is a risk factor for wound complications following posterior lumbar interbody fusionZhongyuan He0Kai Zhou1Ke Tang2Zhengxue Quan3Shaoyu Liu4Bao Su5Department of Orthopedics, The Seventh Affiliated Hospital, Sun Yat-sen UniversityDepartment of Orthopedics, The First Affiliated Hospital of Chongqing Medical UniversityDepartment of Orthopedics, The First Affiliated Hospital of Chongqing Medical UniversityDepartment of Orthopedics, The First Affiliated Hospital of Chongqing Medical UniversityDepartment of Orthopedics, The Seventh Affiliated Hospital, Sun Yat-sen UniversityDepartment of Orthopedics, The First Affiliated Hospital of Chongqing Medical UniversityAbstract Background Although serum albumin levels are increasingly used as an indicator of nutritional status in the clinic, the relationship between perioperative hypoalbuminemia and wound complications after posterior lumbar interbody fusion in the treatment of lumbar degenerative disease remains ambiguous. The aim of this study was to evaluate perioperative serum albumin in relation to postoperative wound complications after posterior lumbar interbody fusion in the treatment of single-segment lumbar degenerative disease. Material and methods We reviewed patients who underwent single-segment posterior lumbar interbody fusion surgery from December 2014 to April 2017 in the Department of Orthopedics at the First Affiliated Hospital of Chongqing Medical University. Perioperative (preoperative and early postoperative) serum albumin levels were assessed in all patients and were used to quantify nutritional status. We divided the patients into a surgical wound dehiscence (SWD) group and a normal wound healing group and into a surgical site infection (SSI) group and a non-SSI group. To evaluate the relationship between perioperative serum albumin level and postoperative wound complications, we conducted univariate and multiple logistic regression analyses. Results A total of 554 patients were enrolled in the study. The univariate and multiple logistic regression analysis of these differences showed that preoperative serum albumin < 3.5 g/dl (P = 0.001) and postoperative serum albumin < 3.0 g/dl (P = 0.001) were significantly correlated to SWD. There were also significant differences between the SSI groups in terms of preoperative serum albumin < 3.5 g/dl (P = 0.001) and chronic steroid use (P = 0.003). Additionally, the increased hospitalization costs (P < 0.001) and length of hospitalization (P < 0.001) were statistically significant for patients with perioperative hypoalbuminemia. Conclusions For patients who underwent single-segment posterior lumbar interbody fusion surgery, we need to pay more attention to perioperative hypoalbuminemia and chronic steroid use, which are more likely to be associated with increased wound complications, hospitalization costs, and length of hospitalization after surgery. Adequate assessment and management of these risk factors will help reduce wound complications and hospital stays for surgical patients and will save medical costs.http://link.springer.com/article/10.1186/s13018-020-02051-4HypoalbuminemiaMalnutritionRisk factorsSingle-segment lumbar fusionSurgical wound dehiscenceRetrospective studies |
| spellingShingle | Zhongyuan He Kai Zhou Ke Tang Zhengxue Quan Shaoyu Liu Bao Su Perioperative hypoalbuminemia is a risk factor for wound complications following posterior lumbar interbody fusion Journal of Orthopaedic Surgery and Research Hypoalbuminemia Malnutrition Risk factors Single-segment lumbar fusion Surgical wound dehiscence Retrospective studies |
| title | Perioperative hypoalbuminemia is a risk factor for wound complications following posterior lumbar interbody fusion |
| title_full | Perioperative hypoalbuminemia is a risk factor for wound complications following posterior lumbar interbody fusion |
| title_fullStr | Perioperative hypoalbuminemia is a risk factor for wound complications following posterior lumbar interbody fusion |
| title_full_unstemmed | Perioperative hypoalbuminemia is a risk factor for wound complications following posterior lumbar interbody fusion |
| title_short | Perioperative hypoalbuminemia is a risk factor for wound complications following posterior lumbar interbody fusion |
| title_sort | perioperative hypoalbuminemia is a risk factor for wound complications following posterior lumbar interbody fusion |
| topic | Hypoalbuminemia Malnutrition Risk factors Single-segment lumbar fusion Surgical wound dehiscence Retrospective studies |
| url | http://link.springer.com/article/10.1186/s13018-020-02051-4 |
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