Patient demographic, comorbidity, and preoperative characteristics in American College of Surgeons National Surgical Quality Improvement Program patients undergoing posterior cervical decompression with or without fusion.
| Variable | Normal (GNRI >98) | Moderately Malnourished (GNRI 92–98) | Severely Malnourished (GNRI <92) | P |
| Age, y, median (IQR) | 72 (68−76) | 73 (68−79) | 74 (69−80) | <0.001 |
| BMI, kg/m2, median (IQR) | 28.7 (25.5–32.4) | 28.3 (24.7–32.5) | 26.3 (22.1–31.3) | <0.001 |
| Gender | ||||
| Male | 2900 (58.5%) | 820 (56.5%) | 685 (57.9%) | 0.402 |
| Female | 2061 (41.5%) | 632 (43.5%) | 499 (42.1%) | |
| BMI cohorts, kg/m2 | ||||
| Underweight (<18.5) | 24 (0.5%) | 34 (2.3%) | 79 (6.7%) | <0.001 |
| Normal weight (18.5–24.9) | 1042 (21.0%) | 359 (24.7%) | 410 (34.6%) | |
| Overweight (25.0–29.9) | 1908 (38.5%) | 491 (33.8%) | 350 (29.6%) | |
| Obese (>30.0) | 1987 (40.1%) | 568 (39.1%) | 345 (29.1%) | |
| Age cohorts, y | ||||
| 65–81 | 4367 (88.0%) | 1189 (81.9%) | 906 (76.5%) | <0.001 |
| 81+ | 594 (12.0%) | 263 (18.1%) | 278 (23.5%) | |
| Race | ||||
| White | 3821 (81.7%) | 1030 (76.4%) | 753 (70.8%) | <0.001 |
| Black | 446 (9.0) | 185 (12.8) | 184 (15.6) | |
| Hispanic | 412 (8.3) | 133 (9.2) | 127 (10.2) | |
| Other | 277 (5.6) | 102 (7.0) | 118 (10.0) | |
| Admission status | ||||
| Inpatient | 4202 (84.7%) | 1290 (88.8%) | 1135 (95.9%) | <0.001 |
| Outpatient | 759 (15.3%) | 162 (11.2%) | 49 (4.1%) | |
| Comorbidities | ||||
| Smoking history | 525 (10.6%) | 210 (14.5%) | 192 (16.2%) | <0.001 |
| Diabetes mellitus | 1315 (26.5) | 429 (29.5) | 350 (29.6) | 0.018 |
| Hypertension requiring medication | 3660 (73.8%) | 1102 (75.9%) | 872 (73.6%) | 0.243 |
| Cerebrovascular accident/transient ischemic attack | 34 (0.7%) | 14 (1.0%) | 18 (1.5%) | 0.019 |
| Hemiplegia/quadraplegia/paraplegia | 33 (0.7%) | 19 (1.3%) | 24 (2.0%) | <0.001 |
| Steroid use | 275 (5.5%) | 126 (8.7%) | 128 (10.8%) | <0.001 |
| >10% weight loss within past 6 mo | 28 (0.6%) | 20 (1.4%) | 50 (4.2%) | <0.001 |
| Disseminated cancer | 102 (2.1%) | 45 (3.1%) | 95 (8.0%) | <0.001 |
| Pulmonary comorbidity | 583 (11.8%) | 246 (16.9%) | 218 (18.4%) | <0.001 |
| Dyspnea | 357 (7.2) | 135 (9.3) | 96 (8.1) | 0.027 |
| Ventilator dependent | 7 (0.1) | 13 (0.9) | 47 (4.0) | <0.001 |
| Chronic obstructive pulmonary disease | 322 (6.5) | 143 (9.8) | 116 (9.8) | <0.001 |
| Cardiac comorbidity | 108 (2.2%) | 40 (2.8%) | 46 (3.9%) | 0.003 |
| Congestive heart failure | 36 (0.7) | 24 (1.7) | 36 (3.0) | <0.001 |
| Prior cardiac intervention | 44 (!2.4) | 10 (10.8) | 7 (8.9) | 0.655 |
| Previous cardiac surgery | 40 (11.2) | 9 (9.7) | 7 (8.9) | 0.784 |
| Renal comorbidity | 21 (0.4%) | 25 (1.7%) | 61 (5.2%) | <0.001 |
| Renal failure | 2 (0.0) | 3 (0.2) | 14 (1.2) | <0.001 |
| On dialysis | 20 (0.4) | 24 (1.7) | 57 (4.8) | <0.001 |
| ASA class > 3 | 3476 (70.1%) | 1164 (80.2%) | 1094 (92.3%) | <0.001 |
| Surgical specialty | ||||
| Orthopedic surgery | 1464 (29.5%) | 397 (27.3%) | 268 (22.6%) | 0.002 |
| Neurosurgery | 3479 (70.1%) | 1049 (72.2%) | 914 (77.2%) | |
| Other subspecialty | 26 (0.4%) | 6 (0.5%) | 2 (0.2%) | |
| Albumin (g/dL) | ||||
| <3.5 | 0 (0.0%) | 217 (14.9%) | 1094 (92.4%) | <0.001 |
| 3.5–3.79 | 0 (0.0%) | 1127 (77.6%) | 70 (5.9%) | |
| ≥3.8 | 4961 (100.0%) | 108 (7.4%) | 20 (1.7%) | |
| ASA classification | ||||
| 1 | 22 (0.4) | 3 (0.2) | 3 (0.3) | <0.001 |
| 2 | 1459 (29.4) | 285 (19.6) | 86 (7.3) | |
| 3 | 3188 (64.3) | 974 (67.1) | 756 (64.0) | |
| 4 | 288 (5.8) | 190 (13.1) | 338 (28.5) | |
| 5 | 0 (0.0) | 0 (0.0) | 0 (0.0) | |
| Levels of repair | ||||
| Single | 4015 (80.5) | 1127 (77.6) | 897 (75.8) | <0.001 |
| Multiple | 946 (19.1) | 325 (22.4) | 287 (24.2) |
Abbreviations: ASA, American Society of Anesthesiologists; BMI, body mass index; GNRI, geriatric nutritional risk index; IQR, interquartile range.
Note: Data presented as n (%) unless otherwise indicated. P values in boldface indicate statistically significant comparisons.