Perioperative malnutrition and its relationship to length of stay and complications in patients undergoing surgery for cervical myelopathy

Abstract

Background: Surgical treatment of cervical myelopathy is common, and the impact of perioperative malnutrition in these patients is unclear; yet, malnutrition pre- And postoperatively has been associated with higher rates of wound infection in spine patients. We evaluated the association of low prealbumin level, a marker for poor nutrition, with length of hospitalization and complication rates after surgery for cervical myelopathy. Methods: We retrospectively identified patients with cervical myelopathy who underwent anterior cervical discectomy and fusion, anterior cervical corpectomy and fusion, or posterior cervical decompression and fusion over a 5-year period. Patients' prealbumin levels were measured within 4 days of surgery; they were divided into low and normal groups (threshold 15 mg/dL). Demographic, clinical, operative, and postoperative parameters were correlated with prealbumin levels by utilizing univariate and multivariable analyses. Results: Eighteen patients were in the 'low prealbumin' group and 37 were in the 'normal prealbumin' group. Patients with low prealbumin were significantly more likely to have an extended length of hospitalization/stay (LOS) (median 6 days, interquartile range 7.5 days vs. median 3 days, interquartile range 2 days, P < 0.001) and more postoperative complications (33% versus 0%, P < 0.001). Multivariable analysis revealed that only the low prealbumin category (P < 0.001) was associated with a prolonged LOS. Conclusions: Low prealbumin levels were associated with prolonged LOS after surgery for cervical myelopathy. We need to better define the effects of malnutrition in patients with cervical myelopathy in the future.