[Impacts of perioperative nutritional screening and management on postoperative infectious complications in geriatric...

Objective: To evaluate the impacts of perioperative nutritional screening and management on postoperative infectious complications in geriatric degenerative spinal deformity surgery. Methods: This retrospective cohort study included elderly patients with degenerative spinal deformity who underwent open posterior thoracolumbar fusion at Xuanwu Hospital, Capital Medical University, from February 2018 to October 2022. A total of 139 patients with malnutrition or at risk of malnutrition, as identified using the Mini Nutritional Assessment-Short Form (MNA-SF), were included. The patients were divided into an intervention group and a control group based on whether they received standardized perioperative nutritional management. Postoperative adverse events, laboratory parameters, and transfusion rates of albumin and blood products were compared between the two groups. Results: Among the 139 patients, 96 were male, and 43 were female, with an average age of (70.72±8.21) years. The control group included 70 patients, while the intervention group included 69 patients. There were no significant differences in preoperative baseline or intraoperative data between the two groups (all P>0.05). The incidence of postoperative infection-related complications was significantly lower in the intervention group compared to the control group [10.1%(7/69) vs 22.9%(16/70), P=0.044]. On postoperative day 3, the levels of serum albumin and prognostic nutritional index (PNI) in the intervention group were higher [(32.40±3.58) vs (30.72±3.17) g/L, 37.85±4.23 vs 35.87±4.57, both P<0.05]. The albumin transfusion rate was lower in the intervention group [31.9%(22/69) vs 48.6%(34/70), P=0.045]. Conclusion: Perioperative nutritional screening and management are safe and effective for elderly patients undergoing open posterior thoracolumbar fusion for degenerative spinal deformity, these measures reduce the incidence of infection-related complications in patients with malnutrition or at risk of malnutrition.