O0820 Oct.3: 4:30pm - Do Routine Nutrition Consults for Neuromuscular Scoliosis Help the Patient or Just the Rankings?

Background: Pre-operative optimization of patients’ nutritional status has been recommended as part of the pre-operative evaluation for neuromuscular scoliosis patients undergoing posterior spinal fusion (PSF). Pre-operative nutrition consults are used as a quality measure of hospitals and orthopaedic programs. This study aims to investigate the efficacy of nutrition consults on pre-operative weight gain and outcomes for neuromuscular scoliosis patients undergoing PSF.

Methods: A retrospective chart review was conducted on patients < 18 years old with neuromuscular scoliosis who underwent posterior spinal fusion. Charts were reviewed for height and weight at 12, 6 and 3 months prior to surgery, nutrition consults, methods of nutritional optimization and post-operative complications. Patients were divided into two cohorts, those who received pre-operative nutrition consults and those who did not. Pre-operative weight gain and complications between groups were compared.

Results: 243 neuromuscular scoliosis patients met inclusion criteria. 46% (111/243) received a pre-operative nutrition consult and 54% (132/243) did not. Mean age at time of surgery was 13.8 ± 2.4 (range: 9.0-17.9). Preoperative nutrition consults led to g-tube placement in 4.5% (5/111) of patients. Mean pre-operative BMI of those who received nutrition consult at 12, 6 and 3 months prior to surgery was 17.5, 19.0 and 18.6 respectively. Mean BMI of those who did not receive a consult was 18.4, 19.2 and 19.7 at 12, 6 and 3 months pre-operatively. There were no differences in 12-month (p=.66), 6-month (p=.79) or 3-month (p=.29) pre-operative change in BMI. There were also no differences in 12-month (p=.10), 6-month (p=.20) or 3-month (p=.10) pre-operative change in absolute weight. Finally, the incidence of infection (p=.52), implant-related complications (p=.12), wound complications (p=.35), reoperation (p=.44) and length of hospital stay (p=.08) between groups were similar.

Conclusion: Pre-operative nutrition consults did not significantly improve pre-operative weight gain and there were no statistical differences post-operatively between rates of infection, implant related complications, wound complications, reoperation or length of hospital stay among neuromuscular scoliosis patients who underwent PSF.