Preoperative CONUT Score Stratifies Risk of Readmission After Posterior Cervical Decompression and Fusion.

Authors

Gregorio Baek, Mitchell Ng, Steven J Banko, William Green, Joshua Mathew, Yulia Lee, Morgan Hitchner, Yasmine Eichbaum, Roy Miloh, Nicole Joh, Abby Skiena, Torsten Fras, Evgeniy V Uvarov, Keyur Patel, Kyle Stump, Alec Giakas, Ali Farooqi, Brandon Martinazzi, Jonathan Dalton, Alan S Hilibrand, Alexander R Vaccaro, Christopher K Kepler, Gregory D Schroeder

Published in

Spine. Aug 28, 2026. Epub Aug 28, 2026.

Abstract

Retrospective Cohort Study.
This study aimed to compare postoperative outcomes between patients of varying nutritional deficiency status as measured by the CONUT score undergoing posterior cervical decompression and fusion (PCDF).
Malnutrition is an established risk factor for poor postoperative outcomes. The COntrolling NUTritional status (CONUT) score has emerged as a novel method of assessing a patient's nutritional status.
Adult patients undergoing primary, elective PCDF (2017-2023) were identified. Patients were included if they had components of the CONUT score, specifically deficiencies in serum albumin, total cholesterol, or lymphocyte counts, within 6 months preoperatively. Data regarding modified 5-item frailty index, demographic/surgical variables, and postoperative outcomes were collected.
206 patients were included and stratified into normal nutritional status, mild nutritional deficiency, and moderate/severe nutritional deficiency. Age, Charlson Comorbidity Index (CCI), and Distressed Community Index differed between cohorts. Length of stay (LOS) correlated with CONUT score (normal: 4.77, mild: 6.20, moderate/severe: 10.0 days; P=0.001). Frequency of inpatient complications (normal: 8.7%, mild: 11.8%, moderate/severe: 33.3%; P=0.017), discharge to home (normal: 84.8%, mild: 82.8%, moderate/severe: 38.1%; P<0.001), and 31-90 day readmissions (normal: 6.52%, mild: 7.53%, moderate/severe: 38.1%; P=0.001) differed between cohorts. Proportion of frail patients (normal: 79.3%, mild: 86.0%, moderate/severe: 100%; P=0.041) and frailty scores (normal: 1.28, mild: 1.70, moderate/severe: 2.38; P<0.001) differed between cohorts. A multivariable regression controlling for CONUT nutritional status, frailty score, CCI Age score, DCI, and discharge to SNF found that only moderate/severe nutritional deficiency was associated with 90-day readmissions (OR: 4.99, 95% CI: 1.40-18.75; P=0.014).
In patients undergoing PCDF, moderate/severe nutritional deficiency was associated with 90-day readmissions independent of comorbidity burden and frailty score. Thus, further investigation of optimizing nutritional status prior to PCDF may be warranted to minimize postoperative healthcare utilization.

PMID:
42704649
Bibliographic data and abstract were imported from PubMed on 08 Sep 2026.

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