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Study: Potential need for nutritional consultation with spine surgery patients

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SCOTTSDALE, Ariz. — Researchers with the University of Massachusetts found that more than 70% of patients undergoing elective spine surgery had low serum albumin levels and about 30% had severe or moderately low prealbumin levels.

“Our study showed that there is an importance in preoperative nutritional screening using these surrogate markers, and our study highlights the possible need for postoperative nutritional supplementation or possible nutritional consults in spine surgery patients,” Hanbing Zhou, MD, said during his presentation at the International Society for the Study of the Lumbar Spine Meeting. “[We] aim to establish a standard protocol in the preoperative and postoperative nutritional treatment in spine surgery patients.”

To evaluate the overall nutritional status of patients undergoing elective spine procedures, Zhou and colleagues conducted a prospective study of 102 consecutive patients who were scheduled for surgery during a 1-month period. The patients had an average age of 53 years and body mass index (BMI) of 28.6.

 

Hanbing Zhou

The researchers drew the patients’ serum albumin and prealbumin levels at one time point in the immediate postoperative period. They defined a normal albumin level as above 3.5 g/dL and a normal prealbumin level as greater than 18 mg/L.

The average serum albumin level for the patients was 3.2 g/dL. “Interesting to note, there were 28% of patients in the postoperative period with less than 3.0 g/dL and 28% of patients had normal albumin levels,” Zhou said. “The rest of the patients, about 44%, were in between.” 

The investigators discovered a statistical difference between patients with normal and abnormal albumin levels, with older patients tending to have abnormal levels. However, the researchers found no significant difference between the normal and abnormal groups for BMI (28.5 vs. 27.24).

They found an average prealbumin level of 20.2 in their study. “[We found] 6% of patients had a severe/low prealbumin level less than 11 mg/L, one quarter of the patients were moderately low from 11mg/L to 18 mg/L, and 70% of the pts had normal prealbumin levels.” Zhou said. “Furthermore, when we compared the patients who had normal prealbumin and patients with a low prealbumin level and looked at their age, we found that patients with normal prealbumin levels tended to be older, and this was statistically significant. Similar trends were not found when we looked at the BMI in the two patient cohort groups.”

Reference:
Zhou H. Paper #55. Presented at: The International Society for the Study of the Lumbar Spine Meeting. May 13-17, 2013; Scottsdale, Ariz.

Disclosure: Zhou has no relevant financial disclosures.