Effect of postoperative hypoalbuminemia and supplement of human serum albumin on the development of surgical site infection following spinal fusion surgery: a retrospective study

Fu, Zhiqiang; Liu, Xiaonan; Tan, Zhiwen; Li, Jianjun; Fu, Dianwa; Zhu, Lingjun

doi:10.1007/s00586-020-06306-w

Cited by 19 publications

(22 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…ALB is an important indicator for evaluating the nutritional status of patients, and it is also a key substance for maintaining blood colloid osmotic pressure (16). Studies have found that surgical stress can lead to loss of ALB or abnormal distribution, reducing the ability of patients to prevent pathogens (17). CRP is an acute phase protein synthesized by the liver.…”

Section: Discussionmentioning

confidence: 99%

The incidence of incision infections after lumbar fusion and the significance of dynamically monitoring serum albumin and C-reactive protein levels

Jiang¹,

Shi²,

Deng³

et al. 2021

Ann Palliat Med

View full text Add to dashboard Cite

Background: To explore the incidence of incision infections and dynamically monitor albumin (ALB) and C-reactive protein (CRP) levels after lumbar fusion.Methods: A total of 1,773 patients undergoing lumbar fusion in our hospital from March 2011 to March 2021 were selected and divided into the infection group and the non-infection group according to whether incision infections occurred postoperatively. The incidence of postoperative incision infections, the pathogenic characteristics and drug resistance of the pathogenic bacteria in patients in the infection group were analyzed. The general clinical data, serum ALB and CRP levels at different time points were compared between the two groups of patients, and the correlation between ALB and CRP levels was analyzed.ROC curve was used to evaluate the predictive value of serum ALB and CRP levels on the incidence of postoperative incision infections.Results: Of the 1,773 patients, 41 (2.31%) experienced postoperative incision infections. A total of 57 pathogens were detected, including 36 gram-negative bacteria (63.16%), 18 gram-positive bacteria (31.58%), and 3 fungi (5.26%). Among gram-negative bacteria, Pseudomonas aeruginosa had the highest resistance to ampicillin. Among gram-positive bacteria, Staphylococcus aureus had the highest resistance to penicillin and erythromycin. The age, BMI, the number of diabetes patients, levels of serum tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6) and procalcitonin (PCT) IL-8 at 1 d after operation in the infection group were significantly higher than those in the non-infection group (P<0.05). The serum ALB and CRP levels of the two groups differed over time, and the differences were statistically significant in terms of time, inter-group, time and inter-group interaction factors (P<0.05). Correlation analysis showed that ALB was significantly negatively correlated with CRP expression. Receiver operating characteristic (ROC) curve analysis showed that the area under the curve (AUC) value of combined ALB and CRP detection was 0.856, which was significantly higher than that of single detection with ALB or CRP (P<0.05).Conclusions: Gram-negative bacterial infection was the main type of incision infection in patients after lumbar fusion. The changes in ALB and CRP levels were related to the incidence of postoperative incision infections.

show abstract

Section: Discussionmentioning

confidence: 99%

The incidence of incision infections after lumbar fusion and the significance of dynamically monitoring serum albumin and C-reactive protein levels

Jiang¹,

Shi²,

Deng³

et al. 2021

Ann Palliat Med

View full text Add to dashboard Cite

show abstract

“…Postoperative day 5 serum albumin levels were 3.3 ± 0.16 g/dL for HAS infusions alone vs. 3.5 ± 0.15 g/dL for infusions combined with nutritional supplements ( p < 0.001) [ 211 ]. Retrospective observational evidence has also suggested that hypoalbuminemia after spinal surgery is not associated with surgical site infection, and that supplementing human serum albumin increased the rate of surgical site infection [ 212 ]. The main limitations of such contradictory studies are the retrospective observational design, missing variables, and low patient numbers, precluding meaningful conclusions.…”

Section: Therapeutic Effects Of Human Albumin Infusion On Infectionmentioning

confidence: 99%

Hypoalbuminemia as Surrogate and Culprit of Infections

Wiedermann¹

2021

IJMS

145

View full text Add to dashboard Cite

Hypoalbuminemia is associated with the acquisition and severity of infectious diseases, and intact innate and adaptive immune responses depend on albumin. Albumin oxidation and breakdown affect interactions with bioactive lipid mediators that play important roles in antimicrobial defense and repair. There is bio-mechanistic plausibility for a causal link between hypoalbuminemia and increased risks of primary and secondary infections. Serum albumin levels have prognostic value for complications in viral, bacterial and fungal infections, and for infectious complications of non-infective chronic conditions. Hypoalbuminemia predicts the development of healthcare-associated infections, particularly with Clostridium difficile. In coronavirus disease 2019, hypoalbuminemia correlates with viral load and degree of acute lung injury and organ dysfunction. Non-oncotic properties of albumin affect the pharmacokinetics and pharmacodynamics of antimicrobials. Low serum albumin is associated with inadequate antimicrobial treatment. Infusion of human albumin solution (HAS) supplements endogenous albumin in patients with cirrhosis of the liver and effectively supported antimicrobial therapy in randomized controlled trials (RCTs). Evidence of the beneficial effects of HAS on infections in hypoalbuminemic patients without cirrhosis is largely observational. Prospective RCTs are underway and, if hypotheses are confirmed, could lead to changes in clinical practice for the management of hypoalbuminemic patients with infections or at risk of infectious complications.

show abstract

“…Furthermore, it is necessary to maintain blood glucose, albumin, and hemoglobin levels in order to achieve a positive outcome. This normal condition is important because hyperglycemia, hypoalbumin and anemia it will cause infection [18] , decrease healing rate of surgical site [19] . Eventually, it will delay of wound and also bond healing.…”

Section: Clinical Discussionmentioning

confidence: 99%

Superconstructs in reconstruction surgery of Charcot foot Brodsky 1: A case report

Pradana

Mustamsir

Mahendra

et al. 2022

International Journal of Surgery Case Reports

View full text Add to dashboard Cite

Introduction Charcot neuropathic osteoarthropathy (CN) is a chronic, progressive condition of joints, soft tissues, and bones. CN causes considerable high mortality and morbidity. A common issue is early diagnosis and appropriate treatment. Thus, the operative treatment is indicated when patients have progressive deformities, infection and ulceration. The superconstructs method for Charcot foot (CF) is considered giving better clinical outcome than other methods. Presentation of case A 61-year-old male admitted to an outpatient clinic with chief complaint of swelling and pain on a left foot with history of diabetes mellitus type 2. From the physical examination, left foot revealed a swelling with rocker bottom deformity and limited range of motion. The radiological examination showed sclerotic appearance of bone deformity metatarsal joint of midfoot of toe. The patients were diagnosed with left Charcot foot Brodsky Type 1, Eichenholtz grade III with diabetes mellitus type 2. Discussion We made superconstructs rather than standard fixation which is frequently inadequate due to changes accompanying the Charcot process. Thus, we performed an adequate reduction of deformity, reduce soft tissue tension, fixation extension beyond a zone of injury, then use of strongest fixation devices that are applied to maximize mechanical function. Conclusion This study showed that superconstructs provide satisfactory clinical and outcomes. This method is useful for achieving construct and stable fixation especially for Charcot foot.

show abstract

Effect of postoperative hypoalbuminemia and supplement of human serum albumin on the development of surgical site infection following spinal fusion surgery: a retrospective study

Cited by 19 publications

References 27 publications

The incidence of incision infections after lumbar fusion and the significance of dynamically monitoring serum albumin and C-reactive protein levels

The incidence of incision infections after lumbar fusion and the significance of dynamically monitoring serum albumin and C-reactive protein levels

Hypoalbuminemia as Surrogate and Culprit of Infections

Superconstructs in reconstruction surgery of Charcot foot Brodsky 1: A case report

Contact Info

Product

Resources

About