Hyongmin Oh, Hoo Seung Lee, Suk Hyung Choe, Ji-Yoon Jung, Kyung Won Shin, Hyung-Chul Lee, Hee-Pyoung Park, Youn Joung Cho
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引用次数: 0
Abstract
Study design: This is a retrospective case-control study.
Objective: This study hypothesized that a low preoperative prognostic nutritional index (PNI) would increase the risk of postoperative delirium in such patients and aimed to prove it.
Summary of background data: Postoperative delirium in elderly patients results in prolonged hospitalization and an increased burden of medical costs. Preoperative PNI is associated with perioperative adverse outcomes following major surgery. However, its independent association with postoperative delirium remains underexplored in elderly patients undergoing spine surgery.
Methods: Perioperative data of 711 patients (age 65 y or older) who underwent spine surgery were retrospectively analyzed. Based on the optimal cutoff value (47.8) of preoperative PNI, patients were classified into the high (n=512) and the low (n=199) PNI groups. To balance baseline characteristics between the 2 groups, stabilized inverse probability weighting (SIPW) was applied, and logistic regression analysis was performed to evaluate the relationships between preoperative PNI and postoperative delirium.
Results: Postoperative delirium developed in 40/711 (5.6%) patients. The incidence of postoperative delirium was markedly higher in the low PNI group than in the high PNI group both before [25 (12.6%) vs. 15 (2.9%), P<0.001] and after [20 (10.1%) vs. 15 (2.9%), P<0.001] SIPW. In logistic regression analysis after SIPW, preoperative PNI <47.8 was associated with increased risk of postoperative delirium [adjusted odds ratio: 3.57 (95% CI: 1.80-7.09), P<0.001].
Conclusions: A low preoperative PNI is an independent predictor of postoperative delirium in elderly patients undergoing spine surgery.
期刊介绍：
Clinical Spine Surgery is the ideal journal for the busy practicing spine surgeon or trainee, as it is the only journal necessary to keep up to date with new clinical research and surgical techniques. Readers get to watch leaders in the field debate controversial topics in a new controversies section, and gain access to evidence-based reviews of important pathologies in the systematic reviews section. The journal features a surgical technique complete with a video, and a tips and tricks section that allows surgeons to review the important steps prior to a complex procedure.
Clinical Spine Surgery provides readers with primary research studies, specifically level 1, 2 and 3 studies, ensuring that articles that may actually change a surgeon’s practice will be read and published. Each issue includes a brief article that will help a surgeon better understand the business of healthcare, as well as an article that will help a surgeon understand how to interpret increasingly complex research methodology. Clinical Spine Surgery is your single source for up-to-date, evidence-based recommendations for spine care.
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