STUDY DESIGN: Retrospective cohort analysis of risk factors in revision spine surgery using a prospectively collected database. OBJECTIVE: To examine the risk of developing early (30-day) complications across obesity level after adjusting for comorbidities in patients undergoing revision spine surgery. SUMMARY OF BACKGROUND DATA: Prior studies suggest obesity influences early complications after primary surgery. The association between obesity and early complications after revision surgery remains to be characterized. METHODS: Data were abstracted from the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database from 2005 to 2012. Adult Caucasian patients undergoing removal/revision of instrumentation or exploration of fusion were included. Patients were categorized by WHO body mass index (BMI, kg/m): Non-Obese (18.5-29.9), Obese Class I (30-34.9), and Obese Class II/III (≥35). Univariate regression was performed to assess the predictive value of obesity level and baseline risk factors in the presence of at least one early complication, and significant predictors were entered into the multivariable model. RESULTS: Of 2538 patients, 57.6% were nonobese, 23% Obese Class I, and 19.4% Obese Class II/III. Obesity was associated with diabetes, hypertension, respiratory disease, and American Society of Anesthesiologists (ASA) score of 3-4 (all P < 0.001). BMI group (P = 0.01), older age (P = 0.008), functional dependence (P < 0.001), ASA 3-4 (P = 0.008), bleeding disorder (P = 0.04), and diabetes (P = 0.016) were identified as univariate predictors for early complications. In the multivariable model, higher BMI (P = 0.04), older age (P = 0.014), and functional dependence (P < 0.001) remained significant predictors for early complications. Notably, patients who were Obese Class II/III (OR 1.66, 95% CI [1.12-2.45]), age ≥75 (OR 1.83, [1.20-2.81]), and functionally dependent (OR 3.02 [1.85-4.94]) had significantly higher risk compared with their reference groups. CONCLUSION: Obesity is an independent risk factor for early complications after revision spine surgery. Although obesity may not contraindicate revision surgery, its status as a modifiable risk factor warrants disclosure and preoperative counseling to optimize outcomes. LEVEL OF EVIDENCE: 3.
STUDY DESIGN: Retrospective cohort analysis of risk factors in revision spine surgery using a prospectively collected database. OBJECTIVE: To examine the risk of developing early (30-day) complications across obesity level after adjusting for comorbidities in patients undergoing revision spine surgery. SUMMARY OF BACKGROUND DATA: Prior studies suggest obesity influences early complications after primary surgery. The association between obesity and early complications after revision surgery remains to be characterized. METHODS: Data were abstracted from the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database from 2005 to 2012. Adult Caucasian patients undergoing removal/revision of instrumentation or exploration of fusion were included. Patients were categorized by WHO body mass index (BMI, kg/m): Non-Obese (18.5-29.9), Obese Class I (30-34.9), and Obese Class II/III (≥35). Univariate regression was performed to assess the predictive value of obesity level and baseline risk factors in the presence of at least one early complication, and significant predictors were entered into the multivariable model. RESULTS: Of 2538 patients, 57.6% were nonobese, 23% Obese Class I, and 19.4% Obese Class II/III. Obesity was associated with diabetes, hypertension, respiratory disease, and American Society of Anesthesiologists (ASA) score of 3-4 (all P < 0.001). BMI group (P = 0.01), older age (P = 0.008), functional dependence (P < 0.001), ASA 3-4 (P = 0.008), bleeding disorder (P = 0.04), and diabetes (P = 0.016) were identified as univariate predictors for early complications. In the multivariable model, higher BMI (P = 0.04), older age (P = 0.014), and functional dependence (P < 0.001) remained significant predictors for early complications. Notably, patients who were Obese Class II/III (OR 1.66, 95% CI [1.12-2.45]), age ≥75 (OR 1.83, [1.20-2.81]), and functionally dependent (OR 3.02 [1.85-4.94]) had significantly higher risk compared with their reference groups. CONCLUSION:Obesity is an independent risk factor for early complications after revision spine surgery. Although obesity may not contraindicate revision surgery, its status as a modifiable risk factor warrants disclosure and preoperative counseling to optimize outcomes. LEVEL OF EVIDENCE: 3.
Authors: Daniel Lubelski; Joseph E Tanenbaum; Taylor E Purvis; Thomas T Bomberger; Courtney Rory Goodwin; Ilya Laufer; Daniel M Sciubba Journal: CNS Oncol Date: 2017-07-18
Authors: Samantha R Horn; Cole A Bortz; Subaraman Ramachandran; Gregory W Poorman; Frank Segreto; Matt Siow; Akhila Sure; Dennis Vasquez-Montes; Bassel Diebo; Jared Tishelman; John Moon; Peter Zhou; Bryan Beaubrun; Shaleen Vira; Cyrus Jalai; Charles Wang; Kartik Shenoy; Omar Behery; Thomas Errico; Virginie Lafage; Aaron Buckland; Peter G Passias Journal: Int J Spine Surg Date: 2019-06-30
Authors: Binwu Sheng; Chaoling Feng; Donglan Zhang; Hugh Spitler; Lu Shi Journal: Int J Environ Res Public Health Date: 2017-02-13 Impact factor: 3.390
Authors: Juan Manuel Vinas-Rios; Martin Sanchez-Aguilar; Fatima Azucena Medina Govea; Viktor Von Beeg-Moreno; Frerk Meyer Journal: Patient Saf Surg Date: 2018-05-21
Authors: 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; John C Liu; Jeffrey C Wang Journal: EClinicalMedicine Date: 2021-05-15
Authors: Han Jo Kim; Alexander Dash; Matthew Cunningham; Frank Schwab; James Dowdell; Jonathan Harrison; Caroline Zaworski; Alexandra Krez; Virginie Lafage; Sanchita Agarwal; Brandon Carlson; Donald J McMahon; Emily M Stein Journal: Bone Date: 2020-11-04 Impact factor: 4.626
Authors: Fabio Cofano; Giuseppe Di Perna; Daria Bongiovanni; Vittoria Roscigno; Bianca Maria Baldassarre; Salvatore Petrone; Fulvio Tartara; Diego Garbossa; Marco Bozzaro Journal: Global Spine J Date: 2021-06-15