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Prognostic Significance of Preoperative Albumin and Prealbumin in Predicting Adverse Events After Posterior Lumbar Interbody Fusion in Elderly Patients
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DOI：10.2147/cia.s605937.png)
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Abstract
En 中文
Sitao Zhang,1,2 Peng Wang,1,2 Shuaikang Wang,1,2 Di Han,1,2 Shibao Lu1,2 1Department of Orthopedics & Elderly Spinal Surgery, Xuanwu Hospital of Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing, 100053, People’s Republic of China; 2Department of Orthopedics, Xuanwu Hospital, Capital Medical University, Beijing, People’s Republic of China Correspondence: Shibao Lu, Department of Orthopedics, Xuanwu Hospital of Capital Medical University, 45 Changchun Street, Xicheng, Beijing, 100053, People’s Republic of China, Tel +86 139-1072-7070, Email shibaolu@xwh.ccmu.edu.cn Background and Aims: There is growing evidence that nutritional status is a predictor of prognosis for elderly patients, However, specific threshold values for albumin and prealbumin are still lacking for elderly patients undergoing posterior lumbar interbody fusion (PLIF) surgery. This study aims to determine these thresholds in elderly PLIF patients and to perform risk stratification analysis using the combination of albumin and prealbumin. Methods: A total of 660 elderly patients undergoing PLIF surgery at Xuan Wu Hospital from November 2018 to April 2024 were included in this retrospective analysis. The optimal cut-off concentrations of albumin and prealbumin for predicting adverse events (AEs) were determined via ROC curve analysis. Subsequently, patients were categorized into four groups according to these cut-off values: Coapa-hh (both markers above cut-off), Coapa-hl (albumin above, prealbumin below), Coapa-lh (albumin below, prealbumin above), and Coapa-ll (both below cut-off). Results: Chi-square analysis revealed that the Coapa-ll group had the highest perioperative complication rate (P < 0.001). Surgical site infection rates were lower in the Coapa-hh (0.90%) and Coapa-hl (0.70%) groups than in the Coapa-lh (5.63%) and Coapa-ll (4.14%) groups (P = 0.023). Patients in the Coapa-hh group also had significantly shorter total and postoperative hospital stays (P = 0.04 and P = 0.019, respectively). Multivariable logistic regression confirmed that the Coapa classification was independently associated with overall complications after PLIF surgery. Conclusion: Our findings suggest that the Coapa should be viewed as a convenient screening tool. It can identify high-risk elderly patients undergoing PLIF surgery who may benefit from perioperative nutritional optimization. This provides valuable guidance for reducing postoperative complications, improving clinical outcomes, and informing nursing interventions. Keywords: nutrition, PLIF, elderly patients, prealbumin, Albumin, complication
Keywords:
nutrition
PLIF
elderly patients
prealbumin
Albumin
complication
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