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Risk Factors for Unplanned Reoperation Within 30 Days Following Elective Posterior Lumbar Spinal Fusion
STUDY DESIGN: Retrospective cohort study. OBJECTIVES: Unplanned reoperation following lumbar spinal fusion is detrimental to patients, providers, and health systems. The aim of this study was to identify risk factors associated with unplanned reoperation following elective posterior lumbar spinal fu...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
SAGE Publications
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6022952/ https://www.ncbi.nlm.nih.gov/pubmed/29977725 http://dx.doi.org/10.1177/2192568217736269 |
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author | Durand, Wesley M. Eltorai, Adam E. M. Depasse, J. Mason Yang, JaeWon Daniels, Alan H. |
author_facet | Durand, Wesley M. Eltorai, Adam E. M. Depasse, J. Mason Yang, JaeWon Daniels, Alan H. |
author_sort | Durand, Wesley M. |
collection | PubMed |
description | STUDY DESIGN: Retrospective cohort study. OBJECTIVES: Unplanned reoperation following lumbar spinal fusion is detrimental to patients, providers, and health systems. The aim of this study was to identify risk factors associated with unplanned reoperation following elective posterior lumbar spinal fusion and assess the reasons for reoperation. METHODS: A retrospective analysis of 22 151 patients from the American College of Surgeons National Surgical Quality Improvement Program data set between 2012 and 2015 was completed. The primary outcome measure was unplanned reoperation within 30 days. Secondary outcome measures were specific diagnoses and procedures associated with unplanned reoperation, as well as time to reoperation from initial procedure. Multiple stepwise logistic regression was employed to determine preoperative variables predictive of unplanned 30-day reoperation. RESULTS: Patients with disseminated cancer (OR = 3.44, P = .0049), weight loss >10% in 6 months prior to surgery (OR = 3.26, P = .0276), bleeding disorders (OR = 1.92, P = .0049), American Society of Anesthesiologists score of 3 (OR = 1.46, P < .0001), body mass index of 35.0 to 39.9 (OR = 1.50, P = .0037), body mass index of ≥40 (OR = 1.83, P < .0001), and multilevel fusion (OR = 1.24, P = .0069) exhibited increased odds of 30-day reoperation. The most common diagnosis associated with reoperation was postoperative infection (n = 121, 21.1% of reoperations). CONCLUSIONS: Predictors and causes of unplanned reoperation within 30 days following elective posterior lumbar spinal fusion are identifiable. In this study cohort, obesity, American Society of Anesthesiologists score, disseminated cancer, weight loss, bleeding disorders, and multilevel fusion were identified as significant risk factors for reoperation. Further research investigating risk factor modification on reoperation in elective posterior lumbar spinal fusion is warranted. |
format | Online Article Text |
id | pubmed-6022952 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | SAGE Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-60229522018-07-05 Risk Factors for Unplanned Reoperation Within 30 Days Following Elective Posterior Lumbar Spinal Fusion Durand, Wesley M. Eltorai, Adam E. M. Depasse, J. Mason Yang, JaeWon Daniels, Alan H. Global Spine J Original Articles STUDY DESIGN: Retrospective cohort study. OBJECTIVES: Unplanned reoperation following lumbar spinal fusion is detrimental to patients, providers, and health systems. The aim of this study was to identify risk factors associated with unplanned reoperation following elective posterior lumbar spinal fusion and assess the reasons for reoperation. METHODS: A retrospective analysis of 22 151 patients from the American College of Surgeons National Surgical Quality Improvement Program data set between 2012 and 2015 was completed. The primary outcome measure was unplanned reoperation within 30 days. Secondary outcome measures were specific diagnoses and procedures associated with unplanned reoperation, as well as time to reoperation from initial procedure. Multiple stepwise logistic regression was employed to determine preoperative variables predictive of unplanned 30-day reoperation. RESULTS: Patients with disseminated cancer (OR = 3.44, P = .0049), weight loss >10% in 6 months prior to surgery (OR = 3.26, P = .0276), bleeding disorders (OR = 1.92, P = .0049), American Society of Anesthesiologists score of 3 (OR = 1.46, P < .0001), body mass index of 35.0 to 39.9 (OR = 1.50, P = .0037), body mass index of ≥40 (OR = 1.83, P < .0001), and multilevel fusion (OR = 1.24, P = .0069) exhibited increased odds of 30-day reoperation. The most common diagnosis associated with reoperation was postoperative infection (n = 121, 21.1% of reoperations). CONCLUSIONS: Predictors and causes of unplanned reoperation within 30 days following elective posterior lumbar spinal fusion are identifiable. In this study cohort, obesity, American Society of Anesthesiologists score, disseminated cancer, weight loss, bleeding disorders, and multilevel fusion were identified as significant risk factors for reoperation. Further research investigating risk factor modification on reoperation in elective posterior lumbar spinal fusion is warranted. SAGE Publications 2017-10-25 2018-06 /pmc/articles/PMC6022952/ /pubmed/29977725 http://dx.doi.org/10.1177/2192568217736269 Text en © The Author(s) 2017 http://creativecommons.org/licenses/by-nc-nd/4.0/ This article is distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 License (http://www.creativecommons.org/licenses/by-nc-nd/4.0/) which permits non-commercial use, reproduction and distribution of the work as published without adaptation or alteration, without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). |
spellingShingle | Original Articles Durand, Wesley M. Eltorai, Adam E. M. Depasse, J. Mason Yang, JaeWon Daniels, Alan H. Risk Factors for Unplanned Reoperation Within 30 Days Following Elective Posterior Lumbar Spinal Fusion |
title | Risk Factors for Unplanned Reoperation Within 30 Days Following Elective Posterior Lumbar Spinal Fusion |
title_full | Risk Factors for Unplanned Reoperation Within 30 Days Following Elective Posterior Lumbar Spinal Fusion |
title_fullStr | Risk Factors for Unplanned Reoperation Within 30 Days Following Elective Posterior Lumbar Spinal Fusion |
title_full_unstemmed | Risk Factors for Unplanned Reoperation Within 30 Days Following Elective Posterior Lumbar Spinal Fusion |
title_short | Risk Factors for Unplanned Reoperation Within 30 Days Following Elective Posterior Lumbar Spinal Fusion |
title_sort | risk factors for unplanned reoperation within 30 days following elective posterior lumbar spinal fusion |
topic | Original Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6022952/ https://www.ncbi.nlm.nih.gov/pubmed/29977725 http://dx.doi.org/10.1177/2192568217736269 |
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