当前位置: X-MOL 学术Eur. Spine J. › 论文详情
Our official English website, www.x-mol.net, welcomes your feedback! (Note: you will need to create a separate account there.)
Impact of chronic hyperlipidemia on perioperative complications in patients undergoing lumbar fusion: a propensity score matching analysis
European Spine Journal ( IF 2.8 ) Pub Date : 2022-08-06 , DOI: 10.1007/s00586-022-07333-5
Mohamed Kamal Mesregah 1, 2 , Paul Mgbam 1 , Zoe Fresquez 1 , Jeffrey C Wang 1 , Zorica Buser 1, 3, 4
Affiliation  

Purpose

Lumbar fusion is widely used to treat degenerative and traumatic conditions of the spine, with various perioperative complications. This study compared lumbar fusion complications in patients with and without chronic hyperlipidemia.

Methods

Using the MSpine division of the PearlDiver database, patients with or without chronic hyperlipidemia who underwent lumbar fusions were identified. The appropriate Current Procedural Terminology (CPT) codes identified patients with single- or multi-level lumbar spinal fusion surgeries. International Classification of Diseases (ICD-9 and ICD-10) codes identified patients with chronic hyperlipidemia. The surgical and medical complications were obtained utilizing the appropriate ICD-9, ICD-10, and CPT codes. Propensity score matching analysis was used to control for confounding factors. Chi-square test was applied to compare the incidence of complications among different groups.

Results

In single-level fusion group, patients with hyperlipidemia had a higher incidence of wound complications (P < 0.001), surgical site infection (P < 0.001), failed back syndrome (P < 0.001), hardware removal (P < 0.001), deep venous thrombosis/pulmonary embolism (P = 0.031), myocardial infarction (P < 0.001) cerebrovascular accident (P < 0.001), renal failure (P < 0.001), sepsis (P < 0.001), and urinary tract infection/incontinence (P < 0.001).

In multi-level fusion group, patients with hyperlipidemia had a higher incidence of nerve root injury (P = 0.034), wound complications (P < 0.001), surgical site infection (P < 0.001), failed back syndrome (P < 0.001), hardware removal (P < 0.001), revision (P = 0.002), myocardial infarction (P < 0.001), renal failure (P < 0.001), and urinary tract infection/incontinence (P < 0.001).

Conclusion

Following lumbar fusion, patients with chronic hyperlipidemia have an increased risk of perioperative complications, including wound complications, surgical site infection, failed back surgery syndrome, hardware removal, myocardial infarction, renal failure, and urinary tract infection/incontinence.



中文翻译:

慢性高脂血症对腰椎融合术患者围手术期并发症的影响:倾向评分匹配分析

目的

腰椎融合术广泛用于治疗脊柱的退行性和创伤性病症,并伴有各种围手术期并发症。本研究比较了慢性高脂血症和非慢性高脂血症患者的腰椎融合并发症。

方法

使用 PearlDiver 数据库的 MSpine 部分,确定了接受腰椎融合术的患有或不患有慢性高脂血症的患者。适当的当前程序术语 (CPT) 代码确定了接受单节段或多节段腰椎融合手术的患者。国际疾病分类(ICD-9 和 ICD-10)代码确定了患有慢性高脂血症的患者。使用适当的 ICD-9、ICD-10 和 CPT 代码获得手术和医疗并发症。倾向得分匹配分析用于控制混杂因素。应用卡方检验比较不同组间并发症的发生率。

结果

单节段融合组中,高脂血症患者伤口并发症(P  < 0.001)、手术部位感染(P  < 0.001)、失败后背综合征(P  < 0.001)、内固定物移除(P  < 0.001)、深部静脉血栓/肺栓塞(P  =0.031)、心肌梗死(P  <0.001)、脑血管意外(P  <0.001)、肾功能衰竭(P  <0.001)、败血症(P  <0.001)、尿路感染/尿失禁(P  < 0.001)。

多节段融合组中,高脂血症患者神经根损伤(P  = 0.034)、伤口并发症(P  < 0.001)、手术部位感染(P  < 0.001)、失败后背综合征(P  < 0.001)、硬件移除 ( P  < 0.001)、翻修 ( P  = 0.002)、心肌梗死 ( P  < 0.001)、肾功能衰竭 ( P  < 0.001) 和尿路感染/尿失禁 ( P  < 0.001)。

结论

腰椎融合术后,慢性高脂血症患者出现围手术期并发症的风险增加,包括伤口并发症、手术部位感染、背部手术失败综合征、内固定物移除、心肌梗塞、肾功能衰竭和尿路感染/尿失禁。

更新日期:2022-08-07
down
wechat
bug