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Prehab the Labs: Predicting Surgical Outcomes in Spine Fractures Through Preoperative Lab Values
Omar Sbaih1, Gabrielle L Dykhouse2, Hikmat R Chmait3
1Georgetown University School of Medicine, Washington, DC, USA.
Global Spine Journal
|December 29, 2025
Summary
Preoperative hypoalbuminemia strongly predicts poor 30-day outcomes in vertebral fracture fixation patients. Other lab values like creatinine and anemia also indicate specific risks, aiding preoperative planning.
Area of Science:
- Orthopedic Surgery
- Neurosurgery
- Perioperative Medicine
- Health Services Research
Background:
- Preoperative laboratory values (PLVs) are crucial for assessing surgical risk.
- Predicting 30-day postoperative outcomes in vertebral fracture fixation is essential for patient management.
- The prognostic utility of specific PLVs in this patient population requires further elucidation.
Purpose of the Study:
- To evaluate the prognostic significance of preoperative laboratory values (PLVs) in predicting 30-day postoperative outcomes.
- To identify specific laboratory abnormalities associated with adverse events after single-level vertebral fracture fixation.
Main Methods:
- Retrospective cohort study utilizing the ACS-NSQIP database (2015-2020).
- Inclusion of adult patients undergoing single-level vertebral fracture fusion.
- Stratification by clinically relevant hypo- and hyper-thresholds for PLVs and multivariate logistic regression analysis.
Main Results:
- Hypoalbuminemia was the strongest independent predictor of mortality (OR 4.05), major complications (OR 1.94), and non-home discharge (OR 1.72).
- Elevated creatinine and leukocytosis were associated with increased mortality and severe complications (Clavien-Dindo IV).
- Preoperative anemia independently predicted prolonged hospitalization.
Conclusions:
- Hypoalbuminemia is a key predictor of adverse 30-day outcomes in patients undergoing vertebral fracture fixation.
- Elevated creatinine, leukocytosis, and anemia independently confer risks for specific postoperative complications.
- Integrating PLVs into preoperative risk stratification can improve patient counseling and perioperative planning.
