1080 Preoperative Prealbumin Level as a Risk Factor for Pseudoarthrosis Following Lumbar Spine Surgery

Abstract

INTRODUCTION: Preoperative nutritional status is essential for predicting postoperative outcomes. Studies have shown that prealbumin levels can be a prognostic indicator for surgical outcomes in spine surgery. METHODS: A retrospective cohort study of 697 patients was conducted between April 1st, 2018, to October 31st, 2022. Collected data included patient demographics, PPL, chronic steroid use, index surgery, length of surgery, postoperative hospital length of stay, 30-day return, and pseudoarthrosis (verified by a board certified neuroradiologist via radiographic imaging). PPL were first analyzed as absolute values, and then categorized as binary values. The first cut point used for binary categorization was =30 and >30. We then repeated statistical analyses similarly using =25, =20, and =15 as additional cut points (all as binary values). RESULTS: Fifty-six patients had pseudoarthrosis (8%), while 641 (92%) did not. There was no statistical difference between patients who had pseudoarthrosis and patients who did not, in terms of age (62 vs. 62.9, p=0.298), BMI (29.9 vs. 29.8, p=0.441), and preoperative prealbumin level (26.6 vs 26.4, p=0.387). There was a significant difference regarding the length of surgery (337.9 mins vs. 253.8, p=0.008) and hospital length of stay (6.2 days vs. 4.2 days, p<0.001) in patients with pseudoarthrosis. Finally, there was no significant difference between PPL and developing pseudoarthrosis when the data was categorized as binary values with cut points at =30 (p=0.595), =25 (p=0.987), =20 (p=0.799), and =15 (p=0.333). CONCLUSIONS: Preoperative nutritional assessment is essential in spine surgery as it can predict postoperative outcomes and recovery. In our cohort of patients, low serum prealbumin levels did not correlate with a higher rate of pseudoarthrosis following lumbar spine surgery.