Cross-sectional study of nutritional status and nutritional support in patients with spinal deformity during orthopedic perioperative period_West China Medical Journal

Authors：

XU Ruifeng ¹ , ZHANG Heli ² , GUO Xinhui ¹ , JIN Jiyan ¹ , MEI Yanan ¹ , RAO Hui ¹ , XU Wei ¹ , SUN Yuting ¹ ,  LI Baohua ³

1. Department of Orthopedics, Peking University Third Hospital, Beijing 100191, P. R. China;
2. Department of Rehabilitation Medicine, Peking University Third Hospital, Beijing 100191, P. R. China;
3. Department of Neurology, Peking University Third Hospital, Beijing 100191, P. R. China;

Corresponding author：

LI Baohua, Email: lianglbh@126.com

Keywords：

Spine deformity; Nutritional status; Nutritional support; Perioperative period

DOI：

10.7507/1002-0179.202108258

Video：

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Objective To investigate the status of nutrition, nutritional support, and postoperative nutrition-related complications in patients with spinal deformity during orthopedic perioperative period. Methods From February to August 2021, patients who underwent spinal orthopedic surgery for spinal deformity in Peking University Third Hospital were collected. A survey was conducted using self-designed questionnaire, including patient’s general information (gender, age, and type of spinal deformity), nutrition-related information (risks of malnutrition, forms of nutritional support), and postoperative nutrition-related complications. Results A total of 39 patients with spinal deformity were enrolled, and 46.2% (18 cases) were at risk of malnutrition. There were a total of 174 times of nutritional support, and 96.0% (167 times) were parenteral nutrition. The patients’ energy intake from nutritional support accounted for 34.41% of the daily goal energy intake averagely. At admission, one day after operation, and at discharge, the prealbumin was (215.51±34.69), (172.85±31.85), and (163.67±29.15) mg/L, respectively, and the hemoglobin was (138.08±15.67), (119.92±18.01), and (117.69±14.76) g/L, respectively, which were significantly lower one day after operation and at discharge than those at admission (P<0.01). The incidence of postoperative nutrition-related complications during hospitalization was 5.1% (2/39). Conclusions Patients undergoing spinal deformity orthopedics are at high risk of overall malnutrition during the perioperative period, their clinical nutritional interventions are mostly based on parenteral nutrition with a single infusion of nutritional preparations, and the nutritional status is not significantly improved. However, the incidence of postoperative nutrition-related complications is low. Standardized nutrition interventions should be strengthened in the future.

Citation： XU Ruifeng, ZHANG Heli, GUO Xinhui, JIN Jiyan, MEI Yanan, RAO Hui, XU Wei, SUN Yuting, LI Baohua. Cross-sectional study of nutritional status and nutritional support in patients with spinal deformity during orthopedic perioperative period. West China Medical Journal, 2021, 36(10): 1377-1381. doi: 10.7507/1002-0179.202108258 Copy

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14.	马宁, 李国栋. FTS理念下早期肠内营养在结直肠癌手术患者治疗中的临床观察. 南京医科大学学报(自然科学版), 2018, 38(4): 505-508, 513.
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18.	Halanski MA, Hildahl B, Amundson LA, et al. Maternal diets deficient in vitamin D increase the risk of kyphosis in offspring: a novel kyphotic porcine model. J Bone Joint Surg Am, 2018, 100(5): 406-415.
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20.	韦小梅, 钱会娟, 孙凌雪, 等. 加速康复外科理念下脊髓损伤患者围手术期营养管理. 华西医学, 2020, 35(10): 1175-1180.

1. Moke L, Overbergh T, Severijns P, et al. The transverse gravitational deviation index, a novel gravity line-related spinal parameter, relates to balance control and health-related quality of life in adults with spinal deformity. Spine (Phila Pa 1976), 2020, 45(1): E25-E36.
2. Siu TL, Rogers JM, Lin K, et al. Custom-made titanium 3-dimensional printed interbody cages for treatment of osteoporotic fracture-related spinal deformity. World Neurosurg, 2018, 111: 1-5.
3. Cheung ZB, Selverian S, Cho BH, et al. Idiopathic scoliosis in children and adolescents: emerging techniques in surgical treatment. World Neurosurg, 2019, 130: e737-e742.
4. Tsirikos AI, Roberts SB, Bhatti E. Incidence of spinal deformity surgery in a national health service from 2005 to 2018: an analysis of 2, 205 children and adolescents. Bone Joint Open, 2020, 1(3): 19-28.
5. Kandwal P, Vijayaraghavan GP, Nagaraja UB, et al. Severe rigid scoliosis: review of management strategies and role of spinal osteotomies. Asian Spine J, 2017, 11(3): 494-503.
6. Adogwa O, Elsamadicy AA, Mehta A, et al. Preoperative nutritional status is an independent predictor of 30-day hospital readmission after elective spine surgery. Spine (Phila Pa 1976), 2016, 41(17): 1400-1404.
7. Phan K, Kim JS, Xu J, et al. Nutritional insufficiency as a predictor for adverse outcomes in adult spinal deformity surgery. Global Spine J, 2018, 8(2): 164-171.
8. 陈仲强, 刘忠军, 党耕町. 脊柱外科学. 北京: 人民卫生出版社, 2019: 668-679.
9. 中华人民共和国国家卫生健康委员会. 临床营养风险筛查. (2013-04-18)[2021-08-25]. http://www.nhc.gov.cn/wjw/yingyang/201308/9c70beb3461e4676aa4afaeed8cdaab5.shtml.
10. World Health Organization. Mean BMI (kg/m²) (age-standardized estimate). [2021-10-19]. https://www.who.int/data/gho/ data/indicators/indicator-details/GHO/mean-bmi-(kg-m-)-(age-standardized-estimate).
11. World Health Organization. World Health Organization releases new Child Growth Standards. (2006-04-27)[2021-10-19]. https://www.who.int/news/item/27-04-2006-world-health-organization-releases-new-child-growth-standards.
12. 中华医学会肠外肠内营养学分会, 中国医药教育协会加速康复外科专业委员会. 加速康复外科围术期营养支持中国专家共识(2019版). 中华消化外科杂志, 2019, 18(10): 897-902.
13. 成柠, 庞宇, 李暄, 等. 某医院脊柱畸形患者住院费用决策树分析. 中国病案, 2020, 21(8): 60-64.
14. 马宁, 李国栋. FTS理念下早期肠内营养在结直肠癌手术患者治疗中的临床观察. 南京医科大学学报(自然科学版), 2018, 38(4): 505-508, 513.
15. 彭南海, 黄迎春. 肠外与肠内营养护理学. 南京: 东南大学出版社, 2018: 33-37.
16. Li X, Yang Y, Ma ZF, et al. Enteral combined with parenteral nutrition improves clinical outcomes in patients with traumatic brain injury. Nutr Neurosci, 2020: 1-7.
17. Hellerman IM, Singer P. Advances in medical nutrition therapy: parenteral nutrition. Nutrients, 2020, 12(3): 717.
18. Halanski MA, Hildahl B, Amundson LA, et al. Maternal diets deficient in vitamin D increase the risk of kyphosis in offspring: a novel kyphotic porcine model. J Bone Joint Surg Am, 2018, 100(5): 406-415.
19. Marin AG, Pratali RR, Marin SM, et al. Age and spinal disease correlate to albumin and vitamin D status. Global Spine J, 2021: 2192568220982561.
20. 韦小梅, 钱会娟, 孙凌雪, 等. 加速康复外科理念下脊髓损伤患者围手术期营养管理. 华西医学, 2020, 35(10): 1175-1180.

West China Medical Journal

Cross-sectional study of nutritional status and nutritional support in patients with spinal deformity during orthopedic perioperative period

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