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Rapid Bodyweight Reduction before Lumbar Fusion Surgery Increased Postoperative Complications

STUDY DESIGN: Retrospective cohort study. PURPOSE: To determine the effects of massive weight loss on perioperative complications after lumbar fusion surgery (LFS). OVERVIEW OF LITERATURE: Patients who are obese are more likely to experience low back pain, which would require LFS. Nonetheless, they...

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Autores principales: Rudy, Hayeem L., Cho, Woojin, Oster, Brittany A., Tarpada, Sandip Parshottam, Moran-Atkin, Erin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Korean Society of Spine Surgery 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7595823/
https://www.ncbi.nlm.nih.gov/pubmed/32213793
http://dx.doi.org/10.31616/asj.2019.0236
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author Rudy, Hayeem L.
Cho, Woojin
Oster, Brittany A.
Tarpada, Sandip Parshottam
Moran-Atkin, Erin
author_facet Rudy, Hayeem L.
Cho, Woojin
Oster, Brittany A.
Tarpada, Sandip Parshottam
Moran-Atkin, Erin
author_sort Rudy, Hayeem L.
collection PubMed
description STUDY DESIGN: Retrospective cohort study. PURPOSE: To determine the effects of massive weight loss on perioperative complications after lumbar fusion surgery (LFS). OVERVIEW OF LITERATURE: Patients who are obese are more likely to experience low back pain, which would require LFS. Nonetheless, they have a higher risk of perioperative complication development compared with individuals who are not obese. METHODS: Patients who underwent LFS at hospitals that participated in the National Surgical Quality Improvement Program database within the United States between 2005 and 2015. Outcomes included 30-day medical complications, surgical complications, and length of stay (LOS). We analyzed a total of 39,742 patients with the use of the International Classification of Disease, ninth revision codes. The patients were categorized in the following two groups: group 1, individuals with a history of massive weight loss within 6 months before LFS, and group 2, individuals without a history of massive weight loss before surgery. Massive weight loss was defined as loss of 10% of total body weight. Patients with a history of malignancy or chronic disease were excluded from the study. Patients in each group were randomly matched based on age, gender, sex, smoking status, and body mass index. Paired two-tailed Student t-tests were used to compare the outcomes. RESULTS: Of the 39,742 patients identified, 129 (0.32%) met the criteria for inclusion in the weight loss group (WL group) and were successfully matched to individuals in the non-weight loss group (non-WL group). Compared with the non-WL group, the WL group had a significantly longer LOS (9.7 vs. 4.0 days, p<0.05), higher surgical site infections (SSIs) (8.0 vs. 3.0, p<0.05), increased number of blood transfusions (40.0 vs. 20.0, p<0.05), and greater deep vein thrombosis (DVTs) (5.0 and 0.00, p<0.05). CONCLUSIONS: On a nationwide scale, rapid weight loss before LFS is associated with a higher rate of postoperative complications, including SSI and DVTs, longer average LOS, and more frequent blood transfusions.
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spelling pubmed-75958232020-11-03 Rapid Bodyweight Reduction before Lumbar Fusion Surgery Increased Postoperative Complications Rudy, Hayeem L. Cho, Woojin Oster, Brittany A. Tarpada, Sandip Parshottam Moran-Atkin, Erin Asian Spine J Clinical Study STUDY DESIGN: Retrospective cohort study. PURPOSE: To determine the effects of massive weight loss on perioperative complications after lumbar fusion surgery (LFS). OVERVIEW OF LITERATURE: Patients who are obese are more likely to experience low back pain, which would require LFS. Nonetheless, they have a higher risk of perioperative complication development compared with individuals who are not obese. METHODS: Patients who underwent LFS at hospitals that participated in the National Surgical Quality Improvement Program database within the United States between 2005 and 2015. Outcomes included 30-day medical complications, surgical complications, and length of stay (LOS). We analyzed a total of 39,742 patients with the use of the International Classification of Disease, ninth revision codes. The patients were categorized in the following two groups: group 1, individuals with a history of massive weight loss within 6 months before LFS, and group 2, individuals without a history of massive weight loss before surgery. Massive weight loss was defined as loss of 10% of total body weight. Patients with a history of malignancy or chronic disease were excluded from the study. Patients in each group were randomly matched based on age, gender, sex, smoking status, and body mass index. Paired two-tailed Student t-tests were used to compare the outcomes. RESULTS: Of the 39,742 patients identified, 129 (0.32%) met the criteria for inclusion in the weight loss group (WL group) and were successfully matched to individuals in the non-weight loss group (non-WL group). Compared with the non-WL group, the WL group had a significantly longer LOS (9.7 vs. 4.0 days, p<0.05), higher surgical site infections (SSIs) (8.0 vs. 3.0, p<0.05), increased number of blood transfusions (40.0 vs. 20.0, p<0.05), and greater deep vein thrombosis (DVTs) (5.0 and 0.00, p<0.05). CONCLUSIONS: On a nationwide scale, rapid weight loss before LFS is associated with a higher rate of postoperative complications, including SSI and DVTs, longer average LOS, and more frequent blood transfusions. Korean Society of Spine Surgery 2020-10 2020-03-30 /pmc/articles/PMC7595823/ /pubmed/32213793 http://dx.doi.org/10.31616/asj.2019.0236 Text en Copyright © 2020 by Korean Society of Spine Surgery This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Clinical Study
Rudy, Hayeem L.
Cho, Woojin
Oster, Brittany A.
Tarpada, Sandip Parshottam
Moran-Atkin, Erin
Rapid Bodyweight Reduction before Lumbar Fusion Surgery Increased Postoperative Complications
title Rapid Bodyweight Reduction before Lumbar Fusion Surgery Increased Postoperative Complications
title_full Rapid Bodyweight Reduction before Lumbar Fusion Surgery Increased Postoperative Complications
title_fullStr Rapid Bodyweight Reduction before Lumbar Fusion Surgery Increased Postoperative Complications
title_full_unstemmed Rapid Bodyweight Reduction before Lumbar Fusion Surgery Increased Postoperative Complications
title_short Rapid Bodyweight Reduction before Lumbar Fusion Surgery Increased Postoperative Complications
title_sort rapid bodyweight reduction before lumbar fusion surgery increased postoperative complications
topic Clinical Study
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7595823/
https://www.ncbi.nlm.nih.gov/pubmed/32213793
http://dx.doi.org/10.31616/asj.2019.0236
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