ArticleJournal of spine surgery (Hong Kong)2018
Chronic obstructive pulmonary disease is an independent predictor for 30-day readmissions following 1- to 2-level posterior lumbar fusions.
Article in Journal of spine surgery (Hong Kong), 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed.
- Complications After Adult Spinal Deformity Surgeries: All Are Not Created Equal.International journal of spine surgery · 2021Article
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5 authors.
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Abstract
backgroundChronic obstructive pulmonary disease (COPD) is a common cause of morbidity and mortality worldwide. Past literature has demonstrated that patients with COPD are at an increased risk of post-operative complications. We assessed the impact of COPD on 30-day outcomes following a 1- to 2-level posterior lumbar fusion (PLF).
methodsThe 2012-2016 American College of Surgeons-National Surgical Quality Improvement Program (ACS-NSQIP) database was queried using current procedural terminology (CPT) codes 22612, 22630 and 22633 to identify patients undergoing PLFs. Only patients undergoing a 1- to 2-level PLF for degenerative spine pathologies were included.
resultsIn total, 1,123 (4.8%) of 23,481 patients undergoing an elective PLF had a diagnosis of COPD at the time of the surgery. Following adjusted logistic regression analysis, COPD was significantly associated with a longer length of stay of >3 days [odds ratio (OR), 1.40; 95% confidence interval (CI): 1.32-1.48; P=0.008], shorter total operative time (OR, 0.83; 95% CI: 0.73-0.94; P=0.003), discharge to skilled nursing care or rehabilitation facility (OR, 1.28; 95% CI: 1.09-1.51; P=0.002), pneumonia (OR, 2.53; 95% CI: 1.62-3.97; P<0.001) and 30-day readmissions (OR, 1.31; 95% CI: 1.03-1.65; P=0.025).
conclusionsPatients with COPD are more likely to have a longer length of stay, discharge to nursing care/rehabilitation facility, and higher risk of pneumonia and readmissions within 30-days following 1- and 2-level PLF. Our analysis of a large national cohort of patients highlights the importance of pre-operative and post-operative medical optimization in these high-risk patients.
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