Impact of Obesity on Outcomes in Adults Undergoing Elective Posterior Cervical Fusion

Phan, Kevin; Kothari, Parth; Lee, Nathan J.; Virk, Sohaib; Kim, Jun; Cho, Samuel K.

doi:10.1097/brs.0000000000001711

Cited by 44 publications

(47 citation statements)

References 21 publications

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“…This indicates that patients with high BMI should be counseled carefully about the risks of postoperative complications. Our findings were consistent with much of the literature regarding the effects of obesity on cervical fusion procedures. Kalanithi et al .…”

Section: Discussionsupporting

confidence: 92%

“…All the studies were conducted in the USA, and were published between 2010 and 2018. All the studies were prospective or retrospective cohort studies except one, which was a retrospective cross‐sectional study. Patients in three studies were categorized into the following groups according to their BMI: underweight (<18.5 kg/m 2 ), normal weight (18.5–24.99 kg/m 2 ), overweight (25–29.99 kg/m 2 ), nonobese (18.5–29.9 kg/m 2 ), obese I (30–34.9 kg/m 2 ), obese II (35–39.9 kg/m 2 ), or obese III (≥40 kg/m 2 ).…”

Section: Resultsmentioning

confidence: 99%

“…Patients in three studies were categorized into the following groups according to their BMI: underweight (<18.5 kg/m 2 ), normal weight (18.5–24.99 kg/m 2 ), overweight (25–29.99 kg/m 2 ), nonobese (18.5–29.9 kg/m 2 ), obese I (30–34.9 kg/m 2 ), obese II (35–39.9 kg/m 2 ), or obese III (≥40 kg/m 2 ). And in the remaining four studies patients were divided into two groups, however, the definition of obesity among them varied greatly, which was >30, 35 or 40 kg/m 2 . Patients in four studies received ACDF, one received posterior cervical fusion, and the remaining two received ACDF or posterior cervical fusion.…”

Section: Resultsmentioning

confidence: 99%

“…All the studies reported the data of overall complications. However, only four studies provided 10 sets of available data.…”

Section: Resultsmentioning

confidence: 99%

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Impact of Elevated Body Mass Index on Surgical Outcomes for Patients Undergoing Cervical Fusion Procedures: A Systematic Review and Meta‐Analysis

Zhang

Chen

et al. 2019

Orthopaedic Surgery

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To investigate whether high body mass index (BMI) had adverse effects on the postoperative outcomes for patients who underwent anterior or posterior cervical fusion procedures. A literature search were conducted in PubMed, Embase, and Web of Science. Comparative or controlled studies that examined the influences of high BMI on postoperative outcomes after cervical fusion procedures were included. Using a fixed‐effect model or random‐effect model, the effects of high BMI were determined by weight mean difference (WMD) with 95% confidence interval (95% CI) or risk ratio (RR) with 95% CI. A total of seven studies were included in this meta‐analysis. The pooled estimate showed that high BMI was associated with longer hospital stay (WMD = 1.61 days, 95% CI: 0.51, 2.71; P = 0.004), longer surgical time (WMD = 4.55, 95% CI: 1.04, 8.07; P = 0.011), higher mortality rate (RR = 3.01, 95% CI: 2.75, 3.29; P < 0.001), and higher postoperative rates of cardiac complication (RR = 1.30, 95% CI: 1.11, 1.52; P = 0.001), deep venous thromboembolism (RR = 2.29, 95% CI: 1.36, 3.86; P = 0.002), and wound complication (RR = 1.69, 95% CI: 1.26, 2.28; P < 0.001). However, there was no significant differences between high and normal BMI groups in terms of Neck Disability Index (WMD = 1.49, 95% CI: −2.34, 5.32; P = 0.447), SF‐36 Mental Component Score (MCS) (WMD = −0.87, 95% CI: −2.09, 0.35; P = 0.164), overall complications (RR = 1.18, 95% CI: 0.80, 1.76; P = 0.399), central nervous system (CNS) complications (RR = 0.68, 95% CI: 0.17, 2.76; P = 0.586), pulmonary complications (RR = 1.46, 95% CI: 0.87, 2.46; P = 0.150), and septic complications (RR = 0.87, 95% CI: 0.32, 2.38; P = 0.785).High BMI seemed to be associated with longer hospital stay, surgical time, and higher postoperative complication rates compared to normal BMI. Therefore, high BMI patients should be counseled carefully regarding the risk of postoperative complications and surgical outcomes after cervical fusion procedures.

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Section: Discussionsupporting

confidence: 92%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

“…All the studies reported the data of overall complications. However, only four studies provided 10 sets of available data.…”

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Impact of Elevated Body Mass Index on Surgical Outcomes for Patients Undergoing Cervical Fusion Procedures: A Systematic Review and Meta‐Analysis

Zhang

Chen

et al. 2019

Orthopaedic Surgery

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show abstract

“…The methodology for definition and collection of variables in the ACS-NSQIP database has been outlined previously. 5 , 22 - 24 Inclusion criteria for adult surgical cases were identified based on the Current Procedural Terminology (CPT) codes for elective ACDF (CPT codes: 22551, 22554, and 63075). Exclusion criteria of the present study included those who underwent spinal deformity surgery, underweight (body mass index [BMI] < 18.5 kg/m 2 ), dependent on ventilator, disseminated cancer, radiotherapy for malignancy within 90 days before operation, pregnancy, tumors of the central nervous system, chemotherapy for malignancy within 30 days before operation, emergency operations, preoperative systemic sepsis, nonelective surgery, acute renal failure, combined approaches, posterior approach (CPT: 22600), and patients with missing preoperative data.…”

Section: Methodsmentioning

confidence: 99%

Effect of Preoperative Anemia on the Outcomes of Anterior Cervical Discectomy and Fusion

Phan

Wang

Kim

et al. 2017

Global Spine Journal

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Study Design:Retrospective cohort study.Objective:Preoperative anemia has been associated with an increased need for blood transfusions and postoperative complications. The effects of anemia on the outcomes of anterior cervical discectomy and fusion (ACDF) have not been explored. The present study aimed to evaluate the association between preoperative anemia and 30-day complications following ACDF surgery.Methods:Data from the American College of Surgeons National Surgical Quality Improvement Program (2005-2012) was used. Preoperative anemia was defined as hematocrit <39% for males and <36% for females. A bivariate analysis was performed on demographic and perioperative variables. Multivariable logistic regression models were employed, adjusting for patient variables, to identify independent risk factors for complications.Results:A total of 3500 patients were included of which 444 (12.7%) were anemic patients. Multivariate analysis was used to quantify the predictive power of anemia on key postoperative outcomes, while controlling for the other statistically significant. Preoperative anemia was found to be a statistically significant predictor of any complication (odds ratio [OR] = 1.853; 95% confidence interval [CI] = 1.17-2.934; P = .0086), pulmonary complications (OR = 3.269; 95% CI = 1.745-6.126; P = .0002), intraoperative blood transfusion (OR = 4.364; 95% CI = 1.48-12.866; P = 0.0076), return to operating theatre (OR = 2.655; 95% CI = 1.539-4.582; P = .0005), and length of hospital stay more than 5 days (OR = 2.151; 95% CI = 1.499-3.085; P < .0001).Conclusion:Preoperative anemia appears to be a significant predictor of perioperative complications, reoperation, and extended length of hospital stay in patients undergoing elective ACDF. Future studies should explore outcomes of treatment of preoperative anemia prior to surgery to determine the optimal management strategy.

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Comorbidity data collection across different spine registries: an evidence map

et al. 2023

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Introduction Comorbidities are significant patient factors that contribute to outcomes after surgery. There is highly variable collection of this information across the literature. To help guide the systematic collection of best practice data, the Australian Spine Registry conducted an evidence map to investigate (i) what comorbidities are collected by spine registries, (ii) how they are collected and (iii) the compliance and completeness in collecting comorbidity data. Method A literature search was performed to identify published studies of adult spine registry data reporting comorbidities. In addition, targeted questionnaires were sent to existing global spine registries to identify the maximum number of relevant results to build the evidence map. Results Thirty-six full-text studies met the inclusion criteria. There was substantial variation in the reporting of comorbidity data; 55% of studies reported comorbidity collection, but only 25% reported the data collection method and 20% reported use of a comorbidity index. The variation in the literature was confirmed with responses from 50% of the invited registries (7/14). Of seven, three use a recognised comorbidity index and the extent and methods of comorbidity collection varied by registry. Conclusion This evidence map identified variations in the methodology, data points and reporting of comorbidity collection in studies using spine registry data, with no consistent approach. A standardised set of comorbidities and data collection methods would encourage collaboration and data comparisons between patient cohorts and could facilitate improved patient outcomes following spine surgery by allowing data comparisons and predictive modelling of risk factors.

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Impact of Obesity on Outcomes in Adults Undergoing Elective Posterior Cervical Fusion

Abstract: 3.

Cited by 44 publications

References 21 publications

Impact of Elevated Body Mass Index on Surgical Outcomes for Patients Undergoing Cervical Fusion Procedures: A Systematic Review and Meta‐Analysis

Impact of Elevated Body Mass Index on Surgical Outcomes for Patients Undergoing Cervical Fusion Procedures: A Systematic Review and Meta‐Analysis

Effect of Preoperative Anemia on the Outcomes of Anterior Cervical Discectomy and Fusion

Comorbidity data collection across different spine registries: an evidence map

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