Postoperative hypoalbuminemia following surgery related to craniosynostosis

Development and Validation of a Nomogram for Predicting Albumin Transfusion After Spinal Tuberculosis Surgery: Based on Propensity Score Matching Analysis

BACKGROUND

There have been few literature reports on the use of perioperative parameters to predict the risk of albumin transfusion after spinal tuberculosis surgery based on the application of nomogram and propensity score matching (PSM) analysis.

OBJECTIVE

The purpose was to predict the risk of albumin transfusion after spinal tuberculosis surgery based on a combination of PSM and nomogram.

METHODS

The clinical data of the patients were collected in our hospital, including preoperative clinical data, preoperative laboratory tests, and postoperative clinical data. All data were divided into 2 groups, including the albumin transfusion group and the non-albumin transfusion group. The PSM analysis was used to adjust the baseline data of the 2 groups. The nomogram was further constructed. The practicability and predictive ability of the model were evaluated.

RESULTS

A total of 494 cases were collected in this article; 102 pairs by PSM analysis were used to construct the nomogram. There were statistical differences in surgical approach, aspartate aminotransferase/alanine aminotransferase levels, drainage, and kyphosis by logistic analysis, and these parameters were included in the construction of the nomogram. The C-index of the prediction model was 0.734. The area under the curve was 0.73 and the net benefit was between 0.13 and 0.99. The calculated C-index was 0.71 by the internal verification method.

CONCLUSIONS

The PSM analysis had a good matching effect and the nomogram had a good predictive ability. Surgical approach, aspartate aminotransferase/alanine aminotransferase levels, drainage, and kyphosis might be predictors of albumin transfusion after spinal tuberculosis surgery.

Pediatric neuroanesthesia

PURPOSE OF REVIEW

A series of recent studies have changed the practice of pediatric neuroanesthesia, improving outcomes and making children's quality of life better.

RECENT FINDINGS

Potential long-term neurologic effects in infants and young children undergoing surgery and anesthesia have been recognized for over a decade. Several recent, well performed studies suggest that hypotension may also be a major contributor to postoperative neurologic impairment in children. Craniosynostosis surgery has also been the subject of extensive study, both related to decreasing blood loss and to optimizing postoperative outcomes.

SUMMARY

Although neurosurgical anesthesia research in the pediatric population can be ethically and logistically complex, resolving questions such as the optimal blood pressure during surgery and best management of infants undergoing repair of craniosynostosis will improve patient outcomes.