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Research ArticleComplications

Low Body Mass Index Patients Undergoing an Anterior Lumbar Fusion May Have an Increased Risk of Perioperative Complications

Mark M. Gleeson, Matthew J. Solomito, Regina O. Kostyun, Sean Esmende and Heeren Makanji
International Journal of Spine Surgery December 2023, 8539; DOI: https://doi.org/10.14444/8539
Mark M. Gleeson
1 School of Medicine, University of Connecticut, Farmington, CT, USA
MSᴄ
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Matthew J. Solomito
2 Department of Orthopedic Research, Hartford HealthCare Bone and Joint Institute, Hartford, CT, USA
PHD
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Regina O. Kostyun
2 Department of Orthopedic Research, Hartford HealthCare Bone and Joint Institute, Hartford, CT, USA
MSEᴅ, ATC
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Sean Esmende
3 Orthopedic Spine Surgery, Orthopedic Associates of Hartford, Hartford, CT, USA
4 Orthopedic Surgery, Hartford HealthCare Bone and Joint Institute, Hartford, CT, USA
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Heeren Makanji
3 Orthopedic Spine Surgery, Orthopedic Associates of Hartford, Hartford, CT, USA
4 Orthopedic Surgery, Hartford HealthCare Bone and Joint Institute, Hartford, CT, USA
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  • For correspondence: Hmakanji@oahctmd.com
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    Figure

    Adverse events after anterior lumbar fusion as a function of body mass index. Abbreviations: BT, blood transfusion; DVT, deep vein thrombosis; HM, hardware malfunction; PE, pulmonary embolism; SSI, surgical site infection; WD, wound dehiscence.

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    Table 1

    ICD-10 codes used to categorize patients according to their BMI.

    BMI (Category)ICD-10 Codes
    <20 (underweight)ICD-10-D-R636 and ICD-10-D-Z681
    20–24.9 (normal weight)ICD-10-D-Z6820, ICD-10-D-Z6821, ICD-10-D-Z6822, ICD-10-D-Z6823, and ICD-10-D-Z6824
    25–29.9 (overweight)ICD-10-D-Z6825, ICD-10-D-Z6826, ICD-10-D-Z6827, ICD-10-D-Z6828, and ICD-10-D-Z6829
    30–34.9 (obesity class I)ICD-10-D-Z6830, ICD-10-D-Z6831, ICD-10-D-Z6832, ICD-10-D-Z6833, and ICD-10-D-Z6834
    35–39.9 (obesity class II)ICD-10-D-Z6835, ICD-10-D-Z6836, ICD-10-D-Z6837, ICD-10-D-Z6838, and ICD-10-D-Z6839
    >40 (obesity class III)ICD-10-D-Z6841, ICD-10-D-Z6842, ICD-10-D-Z6843, ICD-10-D-Z6844, and ICD-10-D-Z6845
    • Abbreviations: BMI, body mass index; ICD-10, International Classification of Diseases, Tenth Revision.

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    Table 2

    Demographic characteristics of patients for each BMI category (N = 14,468).

    Underweight (BMI <20)Normal Weight (BMI 20–24.9)Overweight (BMI 25–29.9)Obesity Class I (BMI 30–34.9)Obesity Class II (BMI 35–39.9)Obesity Class III (BMI >40)
    Demographics n % n % n % n % n % n %
    n 4943.4%170211.8%343323.7%412028.5%276719.1%195213.5%
    Age, y
     <40438.7%20011.8%37911.0%48311.7%33312.0%28214.4%
     40–497314.8%31818.7%68219.9%84420.5%65823.8%49325.3%
     50–5914128.5%44726.3%94027.4%114227.7%79528.7%56428.9%
     60–6912926.1%38222.4%82223.9%105225.5%65923.8%43122.1%
     70–798918.0%34720.4%59417.3%58114.1%31111.2%1748.9%
     80–84<110.0%<110.0%130.4%120.3%<110.0%<110.0%
    Sex
     Woman35571.9%116068.2%206560.2%248260.2%179865.0%138270.8%
     Man13928.1%54231.8%136839.8%163839.8%96935.0%57029.2%
    • Abbreviation: BMI, body mass index.

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    [8539supp001.docx]

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International Journal of Spine Surgery: 19 (S2)
International Journal of Spine Surgery
Vol. 19, Issue S2
1 Apr 2025
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Low Body Mass Index Patients Undergoing an Anterior Lumbar Fusion May Have an Increased Risk of Perioperative Complications
Mark M. Gleeson, Matthew J. Solomito, Regina O. Kostyun, Sean Esmende, Heeren Makanji
International Journal of Spine Surgery Dec 2023, 8539; DOI: 10.14444/8539

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Low Body Mass Index Patients Undergoing an Anterior Lumbar Fusion May Have an Increased Risk of Perioperative Complications
Mark M. Gleeson, Matthew J. Solomito, Regina O. Kostyun, Sean Esmende, Heeren Makanji
International Journal of Spine Surgery Dec 2023, 8539; DOI: 10.14444/8539
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