Effect of Hypoalbuminemia on Outcomes in Non-surgically Treated Patients with Central Cord Injury

Introduction: Central cord syndrome (CCS) is the most common incomplete spinal cord injury in the United States, characterized by motor weakness of the upper extremities with relative sparing of the lower extremities as well as varying degrees of bladder dysfunction and sensory changes caudal to the lesion. Hypoalbuminemia (HA) has previously been associated with poor outcomes following acute spinal cord injury. We hypothesized that patients with CCS and HA had worse outcomes than those without HA.

Methods: Data was collected using the Pearldiver database and included adult patients who were managed nonoperatively for central cord syndrome from 2010 to 2022Q2. Pearson χ2 test and Welch's t-test were used to assess for differences in demographic and clinical data. Univariate analysis and multivariate logistic regression were performed.

Results: HA was associated with an increased risk of the 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.

Conclusion : Patients with hypoalbuminemia after central cord injury are at an increased risk of developing complications such as renal failure and pressure ulcers and may have longer lengths of stay as well as an increase in overall mortality. Surprisingly, respiratory failure, pneumonia, and sepsis were not found to be statistically different between patients with CCS with and without HA. This database study does have limitations, but future case-controlled, prospective studies may further explore complications in CCS patients and hypoalbuminemia.