Affiliation:
1. Spine Research Group, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York;
2. Departments of Neurological Surgery and
3. Orthopedic Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York; and
4. Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
Abstract
OBJECTIVE
Assessment of nutritional status is fundamental in cancer patients. The objective of this study was to assess the predictive ability of 6 nutritional biomarkers for postoperative mortality and wound infection after metastatic spinal tumor surgery.
METHODS
A total of 139 patients who underwent oncological surgery for metastatic spine disease between April 2012 and August 2022 and had a minimum follow-up of 90 days were included. Six unique nutritional biomarkers were assessed: Prognostic Nutritional Index (PNI), Nutritional Risk Index (NRI), Controlling Nutritional Status Score (CONUT), total psoas cross-sectional area (TPA), body mass index (BMI), and body weight. Study endpoints were 90-day mortality rate, 12-month mortality rate, and wound infection. The discriminative ability of each of these markers was assessed with the c-statistic. A multivariate analysis was done for each of the biomarkers after a univariate analysis was first performed.
RESULTS
The 90-day mortality rate was 27% (37 of 139). The biomarkers and respective c-statistics were as follows: PNI (0.74), NRI (0.75), CONUT (0.71), TPA (0.64), BMI (0.59), and body weight (0.60). The 12-month mortality rate was 56% (51 of 91). The biomarkers and respective c-statistics were as follows: PNI (0.72), NRI (0.73), CONUT (0.70), TPA (0.63), BMI (0.59), and body weight (0.60). The wound infection rate was 8% (11 of 139). The biomarkers and respective c-statistics were as follows: PNI (0.57), NRI (0.53), CONUT (0.55), TPA (0.57), BMI (0.48), and body weight (0.52). The PNI, NRI, and CONUT all predicted 90-day and 12-month mortality after multivariate regression analysis. No association between nutrition and wound infection was found.
CONCLUSIONS
In this study, nutritional status was associated with postoperative mortality following oncological spine surgery. Three biomarkers predicted outcome independent of variables such as performance status or primary cancer. Future validation of these metrics is needed.
Publisher
Journal of Neurosurgery Publishing Group (JNSPG)
Reference23 articles.
1. Prevalence of malnutrition in patients at first medical oncology visit: the PreMiO study;Muscaritoli M,2017
2. Frailty and malnutrition predictive of mortality risk in older patients with advanced colorectal cancer receiving chemotherapy;Aaldriks AA,2013
3. Clinical and economic impact of malnutrition per se on the postoperative course of colorectal cancer patients;Melchior JC,2012
4. Prevalence, risk factors and clinical implications of malnutrition in French Comprehensive Cancer Centres;Pressoir M,2010
5. Malnutrition as assessed by nutritional risk index is associated with worse outcome in patients admitted with acute decompensated heart failure: an ACAP-HF data analysis;Aziz EF,2011
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