Evidence map›Paper›PMID 34308307›Full record

ArticleEClinicalMedicine2021

The influence of modifiable risk factors on short-term postoperative outcomes following cervical spine surgery: A retrospective propensity score matched analysis.

Shane Shahrestani, Joshua Bakhsheshian, Xiao T Chen, Andy Ton, Alexander M Ballatori, Ben A Strickland, Djani M Robertson, Zorica Buser, Raymond Hah, Patrick C Hsieh and 2 more

Open access · goldAbstract read
In one paragraph

Article in EClinicalMedicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
1.7field-weighted citation impact, top 16% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 12 citations in OpenAlex.

  1. Lumbar spine fusion in elderly patients: risk factors for failure in achieving favorable outcomes.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2025
    Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 2 institutions in 1 country.

Shane ShahrestaniDepartment of Neurological Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States.
Joshua BakhsheshianDepartment of Neurological Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States.
Xiao T ChenDepartment of Orthopedic Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States.
Andy TonDepartment of Orthopedic Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States.
Alexander M BallatoriDepartment of Orthopedic Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States.
Ben A StricklandDepartment of Neurological Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States.
Djani M RobertsonDepartment of Orthopedic Surgery, NYU Langone Health, New York, NY, United States.
Zorica BuserDepartment of Orthopedic Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States.
Raymond HahDepartment of Orthopedic Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States.
Patrick C HsiehDepartment of Neurological Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States.
John C LiuDepartment of Neurological Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States.
Jeffrey C WangDepartment of Orthopedic Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States.
University of Southern California · USNYU Langone Health · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundModifiable risk factors (MRFs) represent patient variables associated with increased complication rates that may be prevented. There exists a paucity of studies that comprehensively analyze MRF subgroups and their independent association with postoperative complications in patients undergoing cervical spine surgery. Therefore, the purpose of this study is to compare outcomes between patients receiving cervical spine surgery with reported MRFs.

methodsRetrospective analysis of the Nationwide Readmissions Database (NRD) from the years 2016 and 2017, a publicly available and purchasable data source, to include adult patients undergoing cervical fusion. MRF cohorts were separated into three categories: substance abuse (alcohol, tobacco/nicotine, opioid abuse); vascular disease (hypertension, dyslipidemia); and dietary factors (malnutrition, obesity). Three-way nearest-neighbor propensity score matching for demographics, hospital, and surgical characteristics was implemented.

findingsWe identified 9601 with dietary MRFs (D-MRF), 9654 with substance abuse MRFs (SA-MRF), and 9503 with vascular MRFs (V-MRF). Those with d-MRFs had significantly higher rates of medical complications (9.3%), surgical complications (8.1%), and higher adjusted hospital costs compared to patients with SA-MRFs and V-MRFs. Patients with d-MRFs (16.3%) and V-MRFs (14.0%) were independently non-routinely discharged at a significantly higher rate compared to patients with SA-MRFs (12.6%) (

interpretationA large proportion of patients who receive cervical spine surgery have potential MRFs that uniquely influence their postoperative outcomes. A thorough understanding of patient-specific MRF subgroups allows for improved preoperative risk stratification, tailored patient counseling, and postoperative management planning.

fundingNone.

Indexed as

Drug abuseHypertensionMalnutritionObesitySpine

Identifiers

PMID34308307
PMCPMC8257994
OpenAlexW3160469163

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.