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      Association between hypoalbuminemia and complications after degenerative and deformity-correcting spinal surgeries: A systematic review and meta-analysis

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          Abstract

          Objective

          The current review was designed to explore if hypoalbuminemia is associated with increased complications in patients undergoing spinal degenerative and deformities surgeries.

          Methods

          The search for eligible studies was conducted on the databases of PubMed, Embase, Web of Science, and CENTRAL up to 20th June 2022. Complication rates were pooled to obtain odds ratio (OR) and 95% confidence intervals.

          Results

          Thirteen studies were included. We found that hypoalbuminemia was significantly associated with increased risk of all complications (OR: 2.72 95% CI: 2.04, 3.63 I 2 = 58% p < 0.00001), mortality (OR: 7.73 95% CI: 3.81, 15.72 I 2 = 0% p < 0.00001), revision surgery (OR: 3.15 95% CI: 1.53, 6.48 I 2 = 87% p = 0.002), readmissions (OR: 1.96 95% CI: 1.29, 2.98 I 2 = 23% p = 0.02), surgical site infections (OR: 2.97 95% CI: 1.90, 4.63 I 2 = 38% p < 0.00001), wound complications (OR: 2.31 95% CI: 1.17, 4.56 I 2 = 48% p = 0.02), pulmonary complications (OR: 3.74 95% CI: 2.66, 5.26 I 2 = 0% p < 0.00001), renal complications (OR: 3.04 95% CI: 1.22, 7.54 I 2 = 0% p = 0.02), cardiac complications (OR: 4.33 95% CI: 2.14, 8.77 I 2 = 0% p < 0.0001), urinary tract infections (OR: 2.08 95% CI: 1.80, 2.41 I 2 = 0% p < 0.00001), and sepsis (OR: 4.95 95% CI: 1.87, 13.08 I 2 = 64% p = 0.01) as compared to those with normal albumin.

          Conclusion

          Hypoalbuminemia is a significant risk factor for complications after spinal degenerative and deformity surgeries. Research is also needed on the role of nutritional support in improving outcomes after spinal degenerative and deformity surgeries.

          Systematic Review Registration

          https://www.crd.york.ac.uk/prospero/, identifier: CRD42022340024.

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          Most cited references30

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          The PRISMA 2020 statement: An updated guideline for reporting systematic reviews

          The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement, published in 2009, was designed to help systematic reviewers transparently report why the review was done, what the authors did, and what they found. Over the past decade, advances in systematic review methodology and terminology have necessitated an update to the guideline. The PRISMA 2020 statement replaces the 2009 statement and includes new reporting guidance that reflects advances in methods to identify, select, appraise, and synthesise studies. The structure and presentation of the items have been modified to facilitate implementation. In this article, we present the PRISMA 2020 27-item checklist, an expanded checklist that details reporting recommendations for each item, the PRISMA 2020 abstract checklist, and the revised flow diagrams for original and updated reviews.
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            Preoperative serum albumin level as a predictor of postoperative complication after spine fusion.

            Retrospective cohort study.
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              Albumin and surgical site infection risk in orthopaedics: a meta-analysis

              Backgroud Surigical site infection has been a challenge for surgeons for many years, the prevalence of serum albumin 3.5 was 2.39 (95 % CI 1.57 3.64), which was statistically significant (z = 4.06, P < 0.0001). Heterogeneity were found in the pooled MD of albumin and in the pooled RR for infection (P = 0.05, I2 = 61 % and P = 0.003, I2 = 68 %). No publication bias occurred based on two basically symmetrical funnel plots. Conclusion Our meta-analysis demonstrated that an albumin level <3.5 g/dL had an almost 2.5 fold increased risk of SSI in orthopaedics, although this conclusion requires well-designed prospective cohort studies to be confirmed further.
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                Author and article information

                Contributors
                Journal
                Front Surg
                Front Surg
                Front. Surg.
                Frontiers in Surgery
                Frontiers Media S.A.
                2296-875X
                06 January 2023
                2022
                : 9
                : 1030539
                Affiliations
                [ 1 ]Department of Orthopedics Nursing, First Affiliated Hospital of Huzhou University , Huzhou, China
                [ 2 ]Department of Orthopedics, First Affiliated Hospital of Huzhou University , Huzhou, China
                Author notes

                Edited by: Luigi Aurelio Nasto, Giannina Gaslini Institute (IRCCS), Italy

                Reviewed by: Shuaikang Wang, Capital Medical University, China Zhaodong Guo, shenzhen people’s hospital, China

                [* ] Correspondence: Yiping Pan 13587939409@ 123456139.com

                Specialty Section: This article was submitted to Orthopedic Surgery, a section of the journal Frontiers in Surgery

                Article
                10.3389/fsurg.2022.1030539
                9852605
                e0e2ce85-eb2a-47a4-8575-b5312f7f0b1d
                © 2023 Li, Li, Huang and Pan.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 29 August 2022
                : 14 November 2022
                Page count
                Figures: 5, Tables: 1, Equations: 0, References: 31, Pages: 0, Words: 0
                Categories
                Surgery
                Systematic Review

                albumin,nutrition,malnutrition,complications,surgery,spine
                albumin, nutrition, malnutrition, complications, surgery, spine

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