Association of nutritional risk with postoperative functional outcomes in patients undergoing spinal surgery: a retrospective cohort study
- 1Department of Orthopedics, Xinxiang Central Hospital, The Fourth Clinical College of Henan Medical University , ,
Abstract
Background: The role of malnutrition as a predictor of postoperative outcome after spine surgery has been increasingly recognized, although its impact on long-term functional recovery is still poorly understood. The present study aims at analyzing the relationship between malnutrition, according to malnutrition severity criteria, and postoperative functional recovery.
Objectives: To determine whether malnutrition before surgery is related to postoperative recovery and adverse events in elective spine surgery.
Methodology: A retrospective cohort analysis was conducted on 900 patients who underwent elective spinal surgery between 2020 and 2024. They were classified into four groups according to the criteria: no malnutrition (n = 270), mild (n = 324), moderate (n = 198), and severe malnutrition (n = 108). Functional outcomes were measured using ODI, VAS, EQ-5D-5L, FIM, and Barthel Index over 12 months. Multivariable logistic regression, Cox proportional hazards regression, repeated-measures ANOVA, and ROC analyses were performed.
Results: Functional recovery progressively deteriorated as malnutrition became more severe. Mean 12-month ODI score was 16.8 ± 9.4 in no-malnutrition patients, compared to 49.8 ± 15.6 in the severe malnutrition group (p < 0.001); while MCID attainment was 90.4% vs. 63.0%. Postoperative complications occurred in 10.4% vs. 59.3% patients, major complications in 3.7% vs. 24.1% patients, and 30-day mortality occurred in 0% vs. 7.4% patients (all p < 0.001). Severe malnutrition was a strong predictor of poor functional outcome (OR = 5.64, 95% CI 3.32 to 9.58; p < 0.001) and poor functional recovery (HR = 0.46, 95% CI 0.35 to 0.60; p < 0.001).
Conclusion: Malnutrition according to criteria is a significant predictor of poor functional recovery, postoperative complications, and length of stay after spinal surgery. Preoperative nutrition assessment and optimizing nutrition may help improve outcomes after spinal surgery.
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BibTeX
@article{chen2026association,
title = {{Association of nutritional risk with postoperative functional outcomes in patients undergoing spinal surgery: a retrospective cohort study}},
author = {Daodong Chen and Yongbo Yang and Yanjun Guo and Zhenjun Zhu},
journal = {Frontiers in nutrition},
year = {2026},
month = oct,
doi = {10.3389/fnut.2026.1926068},
url = {https://europepmc.org/article/PMC/PMC13727476},
note = {CC BY},
}
RIS
TY - JOUR
TI - Association of nutritional risk with postoperative functional outcomes in patients undergoing spinal surgery: a retrospective cohort study
AU - Daodong Chen
AU - Yongbo Yang
AU - Yanjun Guo
AU - Zhenjun Zhu
PY - 2026
DA - 2026/10/20
JO - Frontiers in nutrition
DO - 10.3389/fnut.2026.1926068
UR - https://europepmc.org/article/PMC/PMC13727476
AB - Background: The role of malnutrition as a predictor of postoperative outcome after spine surgery has been increasingly recognized, although its impact on long-term functional recovery is still poorly understood. The present study aims at analyzing the relationship between malnutrition, according to malnutrition severity criteria, and postoperative functional recovery. Objectives: To determine whether malnutrition before surgery is related to postoperative recovery and adverse events in elective spine surgery. Methodology: A retrospective cohort analysis was conducted on 900 patients who underwent elective spinal surgery between 2020 and 2024. They were classified into four groups according to the criteria: no malnutrition (n = 270), mild (n = 324), moderate (n = 198), and severe malnutrition (n = 108). Functional outcomes were measured using ODI, VAS, EQ-5D-5L, FIM, and Barthel Index over 12 months. Multivariable logistic regression, Cox proportional hazards regression, repeated-measures ANOVA, and ROC analyses were performed. Results: Functional recovery progressively deteriorated as malnutrition became more severe. Mean 12-month ODI score was 16.8 ± 9.4 in no-malnutrition patients, compared to 49.8 ± 15.6 in the severe malnutrition group (p < 0.001); while MCID attainment was 90.4% vs. 63.0%. Postoperative complications occurred in 10.4% vs. 59.3% patients, major complications in 3.7% vs. 24.1% patients, and 30-day mortality occurred in 0% vs. 7.4% patients (all p < 0.001). Severe malnutrition was a strong predictor of poor functional outcome (OR = 5.64, 95% CI 3.32 to 9.58; p < 0.001) and poor functional recovery (HR = 0.46, 95% CI 0.35 to 0.60; p < 0.001). Conclusion: Malnutrition according to criteria is a significant predictor of poor functional recovery, postoperative complications, and length of stay after spinal surgery. Preoperative nutrition assessment and optimizing nutrition may help improve outcomes after spinal surgery.
SN - 2296-861X
ER -