Nutritional Status May Predict Complications of Osteoporotic Vertebral Fracture: A Preliminary Report

Abstract

Introduction: The modified Controlling Nutritional Status (CONUT) score is calculated using laboratory values, including the serum albumin concentration, hemoglobin level, and total lymphocyte count, whereas the prognostic nutritional index (PNI) is calculated using the albumin concentration and total lymphocyte count. Both are valuable tools for nutritional assessment. One notable advantage of the modified CONUT score and PNI over other nutritional assessment methods is that they can be calculated retrospectively using only objective laboratory values. Previous studies have shown that the modified CONUT score is a useful tool to predict the prognosis and complications during hospital care. However, its use as a potential predictive marker for postoperative complications in patients with osteoporotic vertebral fracture (OVF) has been underexplored. The purpose of this study was to investigate the association between nutritional scores and postoperative complications in patients with OVF.

Methods: We included older adults diagnosed with and admitted for OVF from April 2022 to March 2023. Modified CONUT scores and PNI were calculated using the results of routine laboratory tests performed on admission.

Results: A total of 73 patients (30 men and 43 women) were evaluated. Among them, 24 had a normal nutritional status; 41 had mild malnutrition; 8 had moderate malnutrition, and none had severe malnutrition. Complications occurred in 18 of 73 cases (24.7%). The following complications occurred: delirium in nine cases, urinary tract infection in four cases, cerebral infarction in two cases, dehydration in one case, aspiration in one case, and diarrhea in one case. The complication rates were as follows: 4 of 24 (16.7%) in the group with a normal nutritional status, 11 of 42 (26.2%) in the group with mild malnutrition, and 3 of 7 (42.9%) in the group with moderate malnutrition. The cut-off values for the prediction of complications were a modified CONUT score of 3 and PNI of 45.2.

Conclusions: he nutritional indices, using the modified CONUT score and PNI, had predictive value for complications in patients with OVF.