The Impact of Hypoalbuminemia on Outcomes in Non-Surgically Treated Patients With Central Cord Injury.

Abstract

Study designDatabase study.ObjectivesAcute traumatic central cord syndrome (atCCS) is the most common incomplete spinal cord injury in the US, characterized by motor weakness of the upper extremities with relative sparing of the lower extremities and varying degrees of bladder dysfunction and sensory changes caudal to the lesion. Hypoalbuminemia (HA) has previously been associated with poorer outcomes following acute spinal cord injury. We hypothesized that patients with atCCS and HA treated non-surgically experienced worse outcomes than those without HA.MethodsData was collected using the Pearldiver^TM database and included adult patients who sustained atCCS from 2010-2022Q2. Pearson χ2 test and Welch's <i>t</i>-test were used to evaluate differences in demographic and clinical data. Univariate analysis and multivariate logistic regression were performed.ResultsHA in conjunction with non-surgical care of atCCS was associated with an increased risk of development of renal failure and pressure ulcers as well as longer length of stay and two-year mortality. There was no significant increase in odds ratios for 90-day hospital readmission, pneumonia, UTI, respiratory failure, or sepsis.ConclusionsPatients with hypoalbuminemia after atCCS treated non-surgically are at an increased risk of developing complications such as renal failure, pressure ulcers, longer lengths of stay and increased mortality. Surprisingly, respiratory failure, pneumonia, and sepsis were not found to be statistically different between patients with atCCS with and without HA. Inherent to a database study there are predictable limitations, however a large-scale analysis could help further delineate physiologic factors affecting outcomes of atCCS patients.