Christopher J Como, Joshua C Setliff, Jonathan F Dalton, Yunting Melissa Tang, Anthony A Oyekan, Kimberly Hua, Kevin Byrne, Shaan Sadhwani, Michael Spitnale, Kira L Russell, Richard Wawrose, Joon Y Lee, Jeremy D Shaw
{"title":"围手术期集中补充营养可减少脊柱融合手术患者的伤口并发症。","authors":"Christopher J Como, Joshua C Setliff, Jonathan F Dalton, Yunting Melissa Tang, Anthony A Oyekan, Kimberly Hua, Kevin Byrne, Shaan Sadhwani, Michael Spitnale, Kira L Russell, Richard Wawrose, Joon Y Lee, Jeremy D Shaw","doi":"10.1097/BRS.0000000000005136","DOIUrl":null,"url":null,"abstract":"<p><strong>Study design: </strong>Retrospective cohort study.</p><p><strong>Objective: </strong>To evaluate intensive postoperative nutritional supplementation on wound healing complications and outcomes after spinal fusion surgery.</p><p><strong>Background: </strong>Poor nutritional status leads to inferior postoperative outcomes by increasing mortality and predisposing patients to infection and wound-healing complications. While perioperative nutritional supplementation has shown promise in mitigating these risks, there is a paucity of literature regarding specific nutritional routines in spinal fusion surgery.</p><p><strong>Materials and methods: </strong>A retrospective analysis was conducted on patients who underwent spinal fusion surgery between 2019 and 2022. Demographic and nutritional data, including preoperative prealbumin (PAB) levels and postoperative supplemental diet, were examined. Primary endpoints included wound complications, with secondary outcomes assessing Oswestry Disability Index (ODI) and Patient-Reported Outcomes Measurement Information System (PROMIS) Physical Health (PH) scores. Statistical analyses included unpaired t tests and χ 2 /Fischer exact tests with significance set at P <0.05.</p><p><strong>Results: </strong>Patients receiving the supplemental diet (n=229) demonstrated fewer wound complications (7% vs . 21%, P =0.004) and reoperations (3% vs . 11%, P =0.016) compared with those without supplementation (n=56). No significant differences were observed in preoperative or postoperative PROMIS PH or ODI scores. Patients with normal preoperative PAB had more wound complications without the supplemental diet (5% vs . 18%, P =0.025). A similar trend was seen in the patients with low preoperative PAB (12% vs . 26%, P =0.12).</p><p><strong>Conclusion: </strong>Postoperative nutritional supplementation significantly reduces wound complications after spinal fusion surgery in a cost-effective manner. This study underscores the modifiability of certain perioperative risk factors and suggests that nutritional strategies can mitigate potential complications.</p>","PeriodicalId":22193,"journal":{"name":"Spine","volume":" ","pages":"E253-E258"},"PeriodicalIF":2.6000,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Focused Perioperative Nutritional Supplementation Reduces Wound Complications in Patients Undergoing Spinal Fusion Surgery.\",\"authors\":\"Christopher J Como, Joshua C Setliff, Jonathan F Dalton, Yunting Melissa Tang, Anthony A Oyekan, Kimberly Hua, Kevin Byrne, Shaan Sadhwani, Michael Spitnale, Kira L Russell, Richard Wawrose, Joon Y Lee, Jeremy D Shaw\",\"doi\":\"10.1097/BRS.0000000000005136\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Study design: </strong>Retrospective cohort study.</p><p><strong>Objective: </strong>To evaluate intensive postoperative nutritional supplementation on wound healing complications and outcomes after spinal fusion surgery.</p><p><strong>Background: </strong>Poor nutritional status leads to inferior postoperative outcomes by increasing mortality and predisposing patients to infection and wound-healing complications. While perioperative nutritional supplementation has shown promise in mitigating these risks, there is a paucity of literature regarding specific nutritional routines in spinal fusion surgery.</p><p><strong>Materials and methods: </strong>A retrospective analysis was conducted on patients who underwent spinal fusion surgery between 2019 and 2022. Demographic and nutritional data, including preoperative prealbumin (PAB) levels and postoperative supplemental diet, were examined. Primary endpoints included wound complications, with secondary outcomes assessing Oswestry Disability Index (ODI) and Patient-Reported Outcomes Measurement Information System (PROMIS) Physical Health (PH) scores. Statistical analyses included unpaired t tests and χ 2 /Fischer exact tests with significance set at P <0.05.</p><p><strong>Results: </strong>Patients receiving the supplemental diet (n=229) demonstrated fewer wound complications (7% vs . 21%, P =0.004) and reoperations (3% vs . 11%, P =0.016) compared with those without supplementation (n=56). No significant differences were observed in preoperative or postoperative PROMIS PH or ODI scores. Patients with normal preoperative PAB had more wound complications without the supplemental diet (5% vs . 18%, P =0.025). A similar trend was seen in the patients with low preoperative PAB (12% vs . 26%, P =0.12).</p><p><strong>Conclusion: </strong>Postoperative nutritional supplementation significantly reduces wound complications after spinal fusion surgery in a cost-effective manner. 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引用次数: 0
摘要
研究设计回顾性队列研究：评估术后强化营养补充对脊柱融合手术后伤口愈合并发症和预后的影响：背景：不良的营养状况会增加死亡率，使患者容易出现感染和伤口愈合并发症，从而导致术后效果不佳。虽然围手术期营养补充有望降低这些风险，但有关脊柱融合手术中特定营养常规的文献却很少：对 2019 年至 2022 年期间接受脊柱融合手术的患者进行了回顾性分析。对人口统计学和营养数据进行了研究，包括术前白蛋白水平（PAB）和术后补充饮食。主要终点包括伤口并发症，次要结果评估Oswestry残疾指数（ODI）和患者报告结果测量信息系统（PROMIS）身体健康（PH）评分。统计分析包括非配对 t 检验和卡方/费舍尔精确检验，显著性设定为 PResults：接受补充饮食的患者（人数=229）与未接受补充饮食的患者（人数=56）相比，伤口并发症（7% vs. 21%，P=0.004）和再次手术（3% vs. 11%，P=0.016）更少。术前或术后PROMIS PH或ODI评分无明显差异。术前 PAB 正常的患者在没有补充饮食的情况下伤口并发症较多（5% 对 18%，P=0.025）。术前PAB较低的患者也有类似趋势（12% vs. 26%，P=0.12）：结论：术后营养补充能显著减少脊柱融合手术后的伤口并发症，且具有成本效益。这项研究强调了某些围手术期风险因素的可变性，并表明营养策略可减轻潜在的并发症。
Objective: To evaluate intensive postoperative nutritional supplementation on wound healing complications and outcomes after spinal fusion surgery.
Background: Poor nutritional status leads to inferior postoperative outcomes by increasing mortality and predisposing patients to infection and wound-healing complications. While perioperative nutritional supplementation has shown promise in mitigating these risks, there is a paucity of literature regarding specific nutritional routines in spinal fusion surgery.
Materials and methods: A retrospective analysis was conducted on patients who underwent spinal fusion surgery between 2019 and 2022. Demographic and nutritional data, including preoperative prealbumin (PAB) levels and postoperative supplemental diet, were examined. Primary endpoints included wound complications, with secondary outcomes assessing Oswestry Disability Index (ODI) and Patient-Reported Outcomes Measurement Information System (PROMIS) Physical Health (PH) scores. Statistical analyses included unpaired t tests and χ 2 /Fischer exact tests with significance set at P <0.05.
Results: Patients receiving the supplemental diet (n=229) demonstrated fewer wound complications (7% vs . 21%, P =0.004) and reoperations (3% vs . 11%, P =0.016) compared with those without supplementation (n=56). No significant differences were observed in preoperative or postoperative PROMIS PH or ODI scores. Patients with normal preoperative PAB had more wound complications without the supplemental diet (5% vs . 18%, P =0.025). A similar trend was seen in the patients with low preoperative PAB (12% vs . 26%, P =0.12).
Conclusion: Postoperative nutritional supplementation significantly reduces wound complications after spinal fusion surgery in a cost-effective manner. This study underscores the modifiability of certain perioperative risk factors and suggests that nutritional strategies can mitigate potential complications.
期刊介绍：
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Recognized internationally as the leading journal in its field, Spine is an international, peer-reviewed, bi-weekly periodical that considers for publication original articles in the field of Spine. It is the leading subspecialty journal for the treatment of spinal disorders. Only original papers are considered for publication with the understanding that they are contributed solely to Spine. The Journal does not publish articles reporting material that has been reported at length elsewhere.
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