The incidence and risk factors for post-operative ileus after spinal fusion surgery: a multivariate analysis

Kiely, Paul D.; Mount, Lauren; Du, Jerry Y.; Nguyen, Joseph; Weitzman, Gil; Memstoudis, Stavros G.; Waldman, Seth A.; Lebl, Darren R.

doi:10.1007/s00264-016-3148-9

Cited by 34 publications

(28 citation statements)

References 35 publications

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“…Few studies have focused on the risk factors for POI following scoliosis surgery. Most have reported the incidence of POI following spine surgery, which ranges from 0.6% to 16.7% [8][9][10][11] . The present study is the first to identify the incidence of and risk factors for POI after scoliosis surgery, and it revealed two important findings.…”

Section: Discussionmentioning

confidence: 99%

“…Multiple studies have evaluated the risk factors for POI following spine surgery. Such risk factors include a low body mass index, general anesthesia, gastroesophageal reflux disease, intraoperative administration of >2 L/day of crystalloid solutions, and severe constipation 9,10,12,13) . In the present study, the presence of NMS was identified as the main risk factor for POI following scoliosis surgery.…”

Section: Discussionmentioning

confidence: 99%

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Risk Factors for Postoperative Ileus after Scoliosis Surgery

Bureta

Tominaga

Yamamoto

et al. 2018

Spine Surg Relat Res

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Introduction: One complication after scoliosis surgery is ileus; however, few reports have described the frequency of and risk factors for this complication. We conducted a retrospective clinical study with logistic regression analysis to confirm the frequency of and risk factors for ileus after scoliosis surgery. Methods: After a retrospective review of data from patients who underwent surgical correction of spinal deformity from 2009 to 2014, 110 cases (age range, 4-73 yr; median, 14 yr) were included in the study. We defined postoperative ileus (POI) as a surgical complication characterized by decreased intestinal peristalsis and the absence of stool for more than 3 days postoperatively. Various parameters were compared between patients with POI and those without POI. Logistic regression analysis was performed to assess the risk factors associated with ileus; a P value of <0.05 was considered statistically significant. Results: Fifteen of 110 (13.6%) cases developed POI. The median height, weight, operation time, and blood loss volume of the patients with versus without POI were 146 versus 152 cm, 39.0 versus 44.0 kg, 387 versus 359 min, and 1590 versus 1170 g, respectively. There were no significant differences between patients with versus without POI in the measured parameters, with the exception of patient height, bed rest period, and presence of neuromuscular scoliosis. Multiple logistic regression analysis revealed neuromuscular scoliosis as a significant risk factor for POI (odds ratio, 4.21; 95% CI, 1.23-14.40). Conclusions: Our findings indicate a high probability of POI after scoliosis surgery, with an incidence of 13.6%. Neurogenic scoliosis, but not lowest instrumented vertebra or correction rate, was a risk factor for POI after scoliosis surgery. Digestive symptoms should be carefully monitored after surgery, particularly in patients with neuromuscular scoliosis.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Risk Factors for Postoperative Ileus after Scoliosis Surgery

Bureta

Tominaga

Yamamoto

et al. 2018

Spine Surg Relat Res

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“…Applied to scoliosis surgery, a similar protocol was associated with less crystalloid fluid administration, fewer perioperative transfusions, and significantly improved diuresis [192]. Other studies have shown excessive intravenous fluids to be associated with ileus [193,194]. One RCT in spine surgery evaluated the choice of fluid and concluded that normal saline made patients acidotic due to its high chlorine content [195].…”

Section: Summary/recommendationmentioning

confidence: 99%

Consensus statement for perioperative care in lumbar spinal fusion: Enhanced Recovery After Surgery (ERAS®) Society recommendations

et al. 2021

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BACKGROUND: Enhanced Recovery After Surgery (ERAS) evidence-based protocols for perioperative care have led to improvements in outcomes in numerous surgical areas, through multimodal optimization of patient pathway, reduction of complications, improved patient experience and reduction in the length of stay. ERAS represent a relatively new paradigm in spine surgery. PURPOSE: This multidisciplinary consensus review summarizes the literature and proposes recommendations for the perioperative care of patients undergoing lumbar fusion surgery with an ERAS program.FDA device/drug status: not applicable.

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“…This demonstrates not only the high incidence of ileus but also the lack of effective treatments for ileus. The reported incidence of ileus in non-abdominal surgeries is usually lower but varies widely (2-18%) depending on the type of surgery [12][13][14]; however, considering the number of surgery patients, even 2% incidence still accounts for a large number of patients. We recently showed that one-third of moderate to severe trauma patients develop feeding intolerance [2].…”

Section: Introductionmentioning

confidence: 99%

The Role of Inflammatory Mediators in the Development of Gastrointestinal Motility Disorders

Docsa

Sipos

Cox

et al. 2022

IJMS

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Feeding intolerance and the development of ileus is a common complication affecting critically ill, surgical, and trauma patients, resulting in prolonged intensive care unit and hospital stays, increased infectious complications, a higher rate of hospital readmission, and higher medical care costs. Medical treatment for ileus is ineffective and many of the available prokinetic drugs have serious side effects that limit their use. Despite the large number of patients affected and the consequences of ileus, little progress has been made in identifying new drug targets for the treatment of ileus. Inflammatory mediators play a critical role in the development of ileus, but surprisingly little is known about the direct effects of inflammatory mediators on cells of the gastrointestinal tract, and many of the studies are conflicting. Understanding the effects of inflammatory cytokines/chemokines on the development of ileus will facilitate the early identification of patients who will develop ileus and the identification of new drug targets to treat ileus. Thus, herein, we review the published literature concerning the effects of inflammatory mediators on gastrointestinal motility.

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The incidence and risk factors for post-operative ileus after spinal fusion surgery: a multivariate analysis

Abstract: Post-operative ileus is multifactorial in origin, and this study identified intra-operative hydromorphone and post-operative crystalloid fluid administration ≥2 litres as independent risk factors for the development of ileus.

Cited by 34 publications

References 35 publications

Risk Factors for Postoperative Ileus after Scoliosis Surgery

Risk Factors for Postoperative Ileus after Scoliosis Surgery

Consensus statement for perioperative care in lumbar spinal fusion: Enhanced Recovery After Surgery (ERAS®) Society recommendations

The Role of Inflammatory Mediators in the Development of Gastrointestinal Motility Disorders

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