Randomized trial compares postoperative outcomes in malnourished and obese patients, suggesting malnutrition correlates with higher reoperation rates.
Key Points
This research aims to compare the risks of postoperative complications in malnourished versus obese patients undergoing spine surgery.
Adult patients undergoing multi-level posterior lumbar instrumentation for lumbar spinal stenosis or spondylolisthesis were identified from the TriNetX Research Network.
Malnutrition defined as serum albumin <3.5 g/dL and BMI <30 kg/m²; obesity defined as BMI ≥30 kg/m² with serum albumin ≥3.5 g/dL.
Propensity score matching adjusted for age, sex, race, and comorbidities.
Malnourished patients had higher odds of surgical site infection or wound dehiscence than obese/morbidly obese, though not statistically significant.
Malnourished patients had significantly higher odds of reoperation within 90 days than both obese and morbidly obese groups.
Poor nutritional status was a stronger predictor of adverse outcomes than high BMI.