{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T15:43:50Z","timestamp":1791819830790,"version":"4.3.4"},"reference-count":23,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,11,1]]},"abstract":"<jats:sec>\n<jats:title>OBJECTIVE<\/jats:title>\n<jats:p>Assessment of nutritional status is fundamental in cancer patients. The objective of this study was to assess the predictive ability of 6 nutritional biomarkers for postoperative mortality and wound infection after metastatic spinal tumor surgery.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>METHODS<\/jats:title>\n<jats:p>A total of 139 patients who underwent oncological surgery for metastatic spine disease between April 2012 and August 2022 and had a minimum follow-up of 90 days were included. Six unique nutritional biomarkers were assessed: Prognostic Nutritional Index (PNI), Nutritional Risk Index (NRI), Controlling Nutritional Status Score (CONUT), total psoas cross-sectional area (TPA), body mass index (BMI), and body weight. Study endpoints were 90-day mortality rate, 12-month mortality rate, and wound infection. The discriminative ability of each of these markers was assessed with the c-statistic. A multivariate analysis was done for each of the biomarkers after a univariate analysis was first performed.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS<\/jats:title>\n<jats:p>The 90-day mortality rate was 27% (37 of 139). The biomarkers and respective c-statistics were as follows: PNI (0.74), NRI (0.75), CONUT (0.71), TPA (0.64), BMI (0.59), and body weight (0.60). The 12-month mortality rate was 56% (51 of 91). The biomarkers and respective c-statistics were as follows: PNI (0.72), NRI (0.73), CONUT (0.70), TPA (0.63), BMI (0.59), and body weight (0.60). The wound infection rate was 8% (11 of 139). The biomarkers and respective c-statistics were as follows: PNI (0.57), NRI (0.53), CONUT (0.55), TPA (0.57), BMI (0.48), and body weight (0.52). The PNI, NRI, and CONUT all predicted 90-day and 12-month mortality after multivariate regression analysis. No association between nutrition and wound infection was found.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>CONCLUSIONS<\/jats:title>\n<jats:p>In this study, nutritional status was associated with postoperative mortality following oncological spine surgery. Three biomarkers predicted outcome independent of variables such as performance status or primary cancer. Future validation of these metrics is needed.<\/jats:p>\n<\/jats:sec>","DOI":"10.3171\/2023.5.spine23347","type":"journal-article","created":{"date-parts":[[2023,8,5]],"date-time":"2023-08-05T16:32:58Z","timestamp":1691253178000},"page":"664-670","source":"Crossref","is-referenced-by-count":13,"title":["Predictive value of six nutrition biomarkers in oncological spine surgery: a performance assessment for prediction of mortality and wound infection"],"prefix":"10.3171","volume":"39","author":[{"given":"Rafael","family":"De la Garza Ramos","sequence":"first","affiliation":[{"name":"Spine Research Group, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York;"},{"name":"Departments of Neurological Surgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica","family":"Ryvlin","sequence":"additional","affiliation":[{"name":"Spine Research Group, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mousa K.","family":"Hamad","sequence":"additional","affiliation":[{"name":"Spine Research Group, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York;"},{"name":"Departments of Neurological Surgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mitchell S.","family":"Fourman","sequence":"additional","affiliation":[{"name":"Spine Research Group, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York;"},{"name":"Orthopedic Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yaroslav","family":"Gelfand","sequence":"additional","affiliation":[{"name":"Spine Research Group, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York;"},{"name":"Departments of Neurological Surgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saikiran G.","family":"Murthy","sequence":"additional","affiliation":[{"name":"Spine Research Group, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York;"},{"name":"Departments of Neurological Surgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John H.","family":"Shin","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reza","family":"Yassari","sequence":"additional","affiliation":[{"name":"Spine Research Group, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York;"},{"name":"Departments of Neurological Surgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"45","key":"b1","series-title":"Oncotarget","first-page":"79884","article-title":"Prevalence of malnutrition in patients at first medical oncology visit: the PreMiO study","volume":"8","author":"Muscaritoli M","year":"2017","unstructured":"Muscaritoli M, Lucia S, Farcomeni A,  Prevalence of malnutrition in patients at first medical oncology visit: the PreMiO study. Oncotarget. 2017;8(45):79884\u201379896."},{"issue":"3","key":"b2","series-title":"J Geriatr Oncol","first-page":"218","article-title":"Frailty and malnutrition predictive of mortality risk in older patients with advanced colorectal cancer receiving chemotherapy","volume":"4","author":"Aaldriks AA","year":"2013","unstructured":"Aaldriks AA, van der Geest LG, Giltay EJ,  Frailty and malnutrition predictive of mortality risk in older patients with advanced colorectal cancer receiving chemotherapy. J Geriatr Oncol. 2013;4(3):218\u2013226."},{"issue":"6","key":"b3","series-title":"Clin Nutr","first-page":"896","article-title":"Clinical and economic impact of malnutrition per se on the postoperative course of colorectal cancer patients","volume":"31","author":"Melchior JC","year":"2012","unstructured":"Melchior JC, Pr\u00e9aud E, Carles J,  Clinical and economic impact of malnutrition per se on the postoperative course of colorectal cancer patients. Clin Nutr. 2012;31(6):896\u2013902."},{"issue":"6","key":"b4","series-title":"Br J Cancer","first-page":"966","article-title":"Prevalence, risk factors and clinical implications of malnutrition in French Comprehensive Cancer Centres","volume":"102","author":"Pressoir M","year":"2010","unstructured":"Pressoir M, Desn\u00e9 S, Berchery D,  Prevalence, risk factors and clinical implications of malnutrition in French Comprehensive Cancer Centres. Br J Cancer. 2010;102(6):966\u2013971."},{"issue":"1","key":"b5","series-title":"Heart Int","first-page":"e2","article-title":"Malnutrition as assessed by nutritional risk index is associated with worse outcome in patients admitted with acute decompensated heart failure: an ACAP-HF data analysis","volume":"6","author":"Aziz EF","year":"2011","unstructured":"Aziz EF, Javed F, Pratap B,  Malnutrition as assessed by nutritional risk index is associated with worse outcome in patients admitted with acute decompensated heart failure: an ACAP-HF data analysis. Heart Int. 2011;6(1):e2."},{"issue":"9","key":"b6","series-title":"Nippon Geka Gakkai Zasshi","first-page":"1001","article-title":"Prognostic nutritional index in gastrointestinal surgery of malnourished cancer patients","volume":"85","author":"Onodera T","year":"1984","unstructured":"Onodera T, Goseki N, Kosaki G. Prognostic nutritional index in gastrointestinal surgery of malnourished cancer patients. Article in Japanese. Nippon Geka Gakkai Zasshi. 1984;85(9):1001\u20131005."},{"issue":"5","key":"b7","series-title":"Curr Opin Clin Nutr Metab Care","first-page":"322","article-title":"Assessing nutritional status in cancer: role of the Patient-Generated Subjective Global Assessment","volume":"20","author":"Jager-Wittenaar H","year":"2017","unstructured":"Jager-Wittenaar H, Ottery FD. Assessing nutritional status in cancer: role of the Patient-Generated Subjective Global Assessment. Curr Opin Clin Nutr Metab Care. 2017;20(5):322\u2013329."},{"issue":"10","key":"b8","series-title":"Ann Transl Med","first-page":"213","article-title":"Malnutrition in patients who underwent surgery for spinal metastases","volume":"7","author":"Versteeg AL","year":"2019","unstructured":"Versteeg AL, van Tol FR, Lehr AM, Oner FC, Verlaan JJ. Malnutrition in patients who underwent surgery for spinal metastases. Ann Transl Med. 2019;7(10):213."},{"issue":"4","key":"b9","series-title":"Eur Spine J","first-page":"799","article-title":"A systematic review of prognostic factors predicting survival in patients with spinal bone metastases","volume":"27","author":"Bollen L","year":"2018","unstructured":"Bollen L, Jacobs WCH, Van der Linden YM, Van der Hel O, Taal W, Dijkstra PDS. A systematic review of prognostic factors predicting survival in patients with spinal bone metastases. Eur Spine J. 2018;27(4):799\u2013805."},{"issue":"1","key":"b10","series-title":"Nutr Hosp","first-page":"38","article-title":"CONUT: a tool for controlling nutritional status. First validation in a hospital population","volume":"20","author":"Ignacio de Ul\u00edbarri J","year":"2005","unstructured":"Ignacio de Ul\u00edbarri J, Gonz\u00e1lez-Madro\u00f1o A, de Villar NG,  CONUT: a tool for controlling nutritional status. First validation in a hospital population. 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Anesth Analg. 2018;126(5):1763\u20131768."},{"issue":"11","key":"b13","series-title":"Eur J Surg Oncol","first-page":"2074","article-title":"Nutritional assessment in surgical oncology: an ESSO-EYSAC global survey","volume":"46","author":"Lorenzon L","year":"2020","unstructured":"Lorenzon L, Brandl A, Guiral DC,  Nutritional assessment in surgical oncology: an ESSO-EYSAC global survey. Eur J Surg Oncol. 2020;46(11):2074\u20132082."},{"issue":"1","key":"b14","series-title":"World J Surg Oncol","first-page":"170","article-title":"Impact of prognostic nutritional index on long-term outcomes in patients with breast cancer","volume":"14","author":"Mohri T","year":"2016","unstructured":"Mohri T, Mohri Y, Shigemori T, Takeuchi K, Itoh Y, Kato T. Impact of prognostic nutritional index on long-term outcomes in patients with breast cancer. World J Surg Oncol. 2016;14(1):170."},{"issue":"11","key":"b15","series-title":"World J Surg","first-page":"2688","article-title":"Prognostic nutritional index predicts postoperative outcome in colorectal cancer","volume":"37","author":"Mohri Y","year":"2013","unstructured":"Mohri Y, Inoue Y, Tanaka K, Hiro J, Uchida K, Kusunoki M. Prognostic nutritional index predicts postoperative outcome in colorectal cancer. World J Surg. 2013;37(11):2688\u20132692."},{"issue":"7","key":"b16","series-title":"World J Gastroenterol","first-page":"673","article-title":"Nutritional risk index as a predictor of postoperative wound complications after gastrectomy","volume":"18","author":"Oh CA","year":"2012","unstructured":"Oh CA, Kim DH, Oh SJ,  Nutritional risk index as a predictor of postoperative wound complications after gastrectomy. 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Spine (Phila Pa 1976). 2023;48(6):376\u2013383."}],"container-title":["Journal of Neurosurgery: Spine"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-spine\/39\/5\/article-p664.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-spine\/39\/5\/article-p664.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-spine\/39\/5\/article-p664.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,12,6]],"date-time":"2024-12-06T13:13:21Z","timestamp":1733490801000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-spine\/39\/5\/article-p664.xml"}},"subtitle":["Presented at the 2023 AANS\/CNS Joint Section on Disorders of the Spine and Peripheral Nerves"],"short-title":[],"issued":{"date-parts":[[2023,11,1]]},"references-count":23,"journal-issue":{"issue":"5"},"URL":"https:\/\/doi.org\/10.3171\/2023.5.spine23347","relation":{},"ISSN":["1547-5654"],"issn-type":[{"value":"1547-5654","type":"print"}],"subject":[],"published":{"date-parts":[[2023,11,1]]}}}