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