SADA-07 HYPOALBUMINEMIA AS A PROGNOSTIC METRIC IN METASTATIC SPINE DISEASE: A SCOPING REVIEW
Eli Johnson, Jessica Ryvlin, Aruna Seneviratne, Ali Haider Bangash, Michael Weber, Raphaele Charest-Morin, John Shin, Anne Versteeg, Mitchell Fourman, Saikiran Murthy, Yaroslav Gelfand, Reza Yassari, Andrew Hardigan, Rafael De la Garza Ramos, C Rory GoodwinAbstract
Introduction
Poor nutrition status has been associated with poor outcomes in the treatment of oncologic disease, however, there are no defined nutritional indicators for patients with metastatic spine disease (MSD). Hypoalbuminemia has been shown to be a potential biomarker for poor nutritional status in other populations, but the role it plays in the treatment of MSD remains unclear.
Methods
A scoping review of the literature up to December 2022 was conducted using PubMed/ Medline, EMBASE, and Web Science databases. Studies that included patients with MSD, collected albumin levels and reported associated clinical outcomes were included. Baseline health and clinical outcomes data including serum albumin levels, treatments for MSD, ambulatory status, readmission rate, mortality, and complications were collected.
Results
Thirty-eight studies comprising 21,401 patients were analyzed. The majority of studies defined hypoalbuminemia as a binary variable with a level <3.5 g/dL. Twenty-seven (71%) studies evaluated mortality as a primary outcome and 20 of these studies (74%) demonstrated a significant association between albumin levels and survival. A total of 13 studies (34%) included post-treatment complications, 54% of which reported a significant association between hypoalbuminemia and increased risk of complication. Notably only two studies evaluated hypoalbuminemia with regard to discharge disposition, but both studies found a significant association between albumin level and non-routine discharge.
Conclusion
The evidence from this scoping review suggests a threshold of 3.5g/dL is an appropriate definition for hypoalbuminemia in patients with MSD. Many studies demonstrated a correlation between hypoalbuminemia and both operative and non-operative outcomes in patients with MSD.