ArticleFrontiers in nutrition2026
Prognostic nutritional index versus pragmatically operationalized GLIM criteria for predicting postoperative complications and recovery in spine surgery: a prospective cohort study.
Article in Frontiers in nutrition, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Preoperative malnutrition increases surgical complications, yet the Prognostic Nutritional Index (PNI) and Global Leadership Initiative on Malnutrition (GLIM) criteria demonstrate conflicting validity in spine surgery populations. Methods: Prospective outcome cohort with retrospectively abstracted baseline data, comprising 1,341 consecutive spine surgery patients (Chinese tertiary center, February 2022-September 2025) stratified by PNI (normal ≥45 vs. low <45) and GLIM criteria. Baseline clinical and demographic variables were extracted from electronic medical records; all postoperative outcomes were ascertained prospectively using predetermined protocols. Outcomes: 30-day major complications (primary), healthcare utilization, and 90-day patient-reported recovery. Analysis: multivariable logistic regression, AUC comparison, net reclassification improvement. Results: Among 1,341 consecutive spine surgery patients (mean age 54.8 years, 46.8% female, 84.9% elective), low PNI (6.5%, Conclusion: PNI independently predicts perioperative complications and 90-day recovery trajectories in spine surgery patients, whereas the pragmatic GLIM operationalization employed in this study demonstrated no significant prognostic associations. Whether a fully resourced GLIM implementation with imaging-based muscle assessment would perform differently remains to be established.
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