title: Nutritional deficiencies after staged anterior and posterior spinal reconstructive surgery.
abstract: The nutritional status was analyzed in 37 patients being treated with staged anterior and posterior spinal reconstructive procedures. Using stringent criteria for nutritional and immunologic incompetency, 31 patients (84%) became malnourished during hospitalization. Although the serum albumin on admission had been normal for all patients, it became significantly depressed in 77% following anterior and posterior spinal procedures. In a similar fashion, the total lymphocyte count became significantly depressed in 92%. The postoperative complications were clearly more extensive in patients who were malnourished and immune-deficient using these criteria--15 patients with urinary tract infections, four patients with bacterial sepsis, four patients with wound infections, and four patients with pneumonia (vs. one with a wound infection in the adequately nourished group). The length of hospitalization following the second operative procedure was significantly longer in the malnourished group: 16.2 days versus 12.4 days (p less than 0.05). The main purpose of this study is to create awareness of the ongoing nutritional demands placed on patients treated by two-stage spinal reconstruction surgical procedures. More aggressive nutritional intervention can reduce postoperative complications and length of hospital stay and improve the speed of functional recovery.
authors.affiliation: University of California School of Medicine, Division of Orthopaedic Surgery, Los Angeles 90024.
authors.forename: B R
authors.initials: BR
authors.lastname: Mandelbaum
authors.forename: V T
authors.initials: VT
authors.lastname: Tolo
authors.forename: P C
authors.initials: PC
authors.lastname: McAfee
authors.forename: P
authors.initials: P
authors.lastname: Burest
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001424:Bacterial Infections / Q000209:etiology; D002648:Child; D005260:Female; D006801:Humans; D007902:Length of Stay; D007958:Leukocyte Count; D008214:Lymphocytes; D008297:Male; D008875:Middle Aged; D009748:Nutrition Disorders / Q000150:complications* / Q000209:etiology / Q000276:immunology; D011014:Pneumonia / Q000209:etiology; D011183:Postoperative Complications / Q000209:etiology*; D012086:Reoperation; D012189:Retrospective Studies; D012709:Serum Albumin / Q000378:metabolism; D013131:Spine / Q000601:surgery*; D013530:Surgical Wound Infection / Q000209:etiology; D014552:Urinary Tract Infections / Q000209:etiology
chemical_list: D012709:Serum Albumin