Association Between Nutritional Status and Survival in Patients Requiring Treatment for Spinal Metastases.
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Versteeg Anne L, Charest-Morin Raphaële, De La Garza Ramos Rafael, Laufer Ilya, Teixeira William G J, Barzilai Ori, Gasbarrini Alessandro, Fehlings Michael G, Chou Dean, Gokaslan Ziya L, Netzer Cordula, Luzzati Alessandro, Verlaan Jorrit-Jan, Goldschlager Tony, Shin John H, O'Toole John E, Sciubba Daniel M, Bettegowda Chetan, Clarke Michelle J, Weber Michael H, Mesfin Addisu, Kawahara Norio, Patel Shalin S, Goodwin C Rory, Disch Alexander C, Reynolds Jeremy J, Lazary Aron, Boriani Stefano, Dea Nicolas, Sahgal Arjun, Rhines Laurence D, Fisher Charles G, AO Spine Knowledge Forum Tumor
Аннотация
METHODS: Patients with spinal metastases who underwent surgery and/or radiation therapy for symptomatic spinal metastases were enrolled in the AO Spine Metastatic Tumor Research and Outcomes Network, a prospective international multicenter research registry, between September 2017 and August 2022. Using the PG-SGA, nutritional status was classified into 3 categories: A, well nourished; B, moderately malnourished; and C, severely malnourished.
RESULTS: A total of 589 patients met the inclusion criteria; 362 were classified as well nourished (61%), 159 were moderately malnourished (27%), and 68 were severely malnourished (12%). The median survival was 491 days, 328 days, and 117 days for well-nourished, moderately malnourished, and severely malnourished patients, respectively. In the multivariate analyses, severe malnourishment (HR 2.5 95% CI 1.4-4.3, P < .01) and an ECOG performance status of 3 or 4 (HR 2.7 95% CI 1.2-6.0) remained associated with significantly worse survival.
CONCLUSION: Malnutrition as measured by the PG-SGA demonstrated to be significantly and independently associated with postoperative survival. The PG-SGA is a simple and useful tool to identify spinal metastases patients at risk of early postoperative mortality, and inclusion in the preoperative evaluation of these patients should be considered.