Malnutrition and Adverse Outcomes after Spine Surgery: A Systematic Review and Meta-Analysis
Abstract
BACKGROUND CONTEXT
Malnutrition is linked to adverse surgical outcomes, but its impact in spine surgery remains unclear due to inconsistent findings and heterogeneous definitions, including use of serum albumin, prealbumin, lymphocyte count, the Geriatric Nutritional Risk Index, and the Prognostic Nutritional Index. We conducted a systematic review and meta-analysis to evaluate the relationship between malnutrition and postoperative outcomes in spine surgery.
PURPOSE
To systematically evaluate the association between preoperative malnutrition and postoperative outcomes in patients undergoing spine surgery.
STUDY DESIGN
Systematic review and meta-analysis.
PATIENT SAMPLE
Patients undergoing elective or urgent spine surgery across included observational studies comparing malnourished versus well-nourished cohorts.
OUTCOME MEASURES
Primary outcomes included postoperative mortality and overall surgical complications. Secondary outcomes included infectious complications (sepsis, urinary tract infection, wound complications), delirium, reoperation, 30-day and 90-day readmission, and prolonged length of hospital stay.
METHODS
A systematic search of PubMed, Embase, Cochrane Library, and Web of Science was performed on April 7, 2025, following PRISMA guidelines. Studies directly comparing postoperative outcomes in malnourished versus well-nourished spine surgery patients were included. A random-effects model generated pooled odds ratios for complications. Outcomes assessed included…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 16,987 participants or records.
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