{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T21:03:31Z","timestamp":1793394211839,"version":"4.5.0"},"reference-count":23,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,8]]},"abstract":"\n OBJECTIVE<\/jats:title>\n Many complications are likely to occur in patients with malnutrition. The prognostic nutritional index (PNI) is often used when evaluating a patient\u2019s nutritional condition. However, no studies have investigated the association between nutritional status and postoperative medical complications or prognosis by using the PNI in the field of spinal surgery. The purpose of this retrospective study was to investigate postoperative medical complications and prognoses of patients who had undergone adult spinal deformity (ASD) surgery, according to their preoperative nutritional status.<\/jats:p>\n <\/jats:sec>\n \n METHODS<\/jats:title>\n All patients aged \u2265 40 years who had undergone scheduled ASD surgery in the authors\u2019 hospital between March 2010 and June 2017 were eligible for study inclusion and were divided into groups according to their PNI (< 50, group L; \u2265 50, group H). Medical complications diagnosed within 30 days postoperatively were evaluated; however, surgical site infection and death were evaluated until 1 and 5 years after surgery, respectively.<\/jats:p>\n <\/jats:sec>\n \n RESULTS<\/jats:title>\n \n Among the 285 eligible patients, groups L and H consisted of 118 and 167 patients, whose mean ages were 68.6 and 68.3 years, respectively. There was a significant difference in body mass index (22 vs 24 mg\/kg\n 2<\/jats:sup>\n , respectively, p = 0.000), PNI (46 vs 55, p = 0.000), comorbidity of osteoporosis (50% vs 32%, p = 0.005) and autoimmune disease (13% vs 5%, p = 0.036), medical history of malignant disorder (17% vs 6%, p = 0.007), and medical complications (49% vs 23%, p = 0.000) between groups L and H. Multiple logistic regression analysis suggested that significant risk factors for postoperative medical complications were male sex (p = 0.000, OR 3.5, 95% CI 1.78\u20136.96), PNI < 50 (p = 0.000, OR 2.9, 95% CI 1.69\u20134.93), and days to ambulation (p = 0.003, OR 1.1, 95% CI 1.02\u20131.09).\n <\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS<\/jats:title>\n Medical complication rates are significantly higher in patients with PNI < 50, those with delayed ambulation, and male patients. In malnourished patients scheduled for ASD surgery, improvement of preoperative nutritional status and postoperative early ambulation are important to avoid medical complications.<\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/2020.1.spine191410","type":"journal-article","created":{"date-parts":[[2020,4,3]],"date-time":"2020-04-03T19:01:18Z","timestamp":1585940478000},"page":"219-224","source":"Crossref","is-referenced-by-count":51,"title":["Association between a prognostic nutritional index less than 50 and the risk of medical complications after adult spinal deformity surgery"],"prefix":"10.3171","volume":"33","author":[{"given":"Shin","family":"Oe","sequence":"first","affiliation":[{"name":"Department of Orthopedic Surgery and Division of Geriatric Musculoskeletal Health, Hamamatsu University School of Medicine;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu","family":"Yamato","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery and Division of Geriatric Musculoskeletal Health, Hamamatsu University School of Medicine;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomohiko","family":"Hasegawa","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Hamamatsu University School of Medicine; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Go","family":"Yoshida","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Hamamatsu University School of Medicine; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sho","family":"Kobayashi","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Hamamatsu Medical Center, Hamamatsu, Shizuoka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tatsuya","family":"Yasuda","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Hamamatsu University School of Medicine; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomohiro","family":"Banno","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Hamamatsu University School of Medicine; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hideyuki","family":"Arima","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Hamamatsu University School of Medicine; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuki","family":"Mihara","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Hamamatsu University School of Medicine; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroki","family":"Ushirozako","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Hamamatsu University School of Medicine; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomohiro","family":"Yamada","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Hamamatsu University School of Medicine; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koichiro","family":"Ide","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Hamamatsu University School of Medicine; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuh","family":"Watanabe","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Hamamatsu University School of Medicine; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yukihiro","family":"Matsuyama","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Hamamatsu University School of Medicine; and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"11","key":"b1","series-title":"Arch Surg","doi-asserted-by":"publisher","first-page":"1072","DOI":"10.1001\/archsurg.142.11.1072","article-title":"Adverse outcomes of geriatric patients undergoing abdominal surgery who are at high risk for delirium","volume":"142","author":"Ganai S","year":"2007","unstructured":"Ganai S, Lee KF, Merrill A, . 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