Article Figures & Data
Figures
- Figure
Correlation of Delta Patient-Reported Outcomes Measurement Information System physical function (PROMIS-PF) and body mass index (BMI) at (A) 6 weeks, (B) 12 weeks, (C) 6 months, (D) 1 year, and (E) 2 years.
Tables
Characteristic Nonobese
(N = 74)Obese I
(N = 27)Obese II
(N = 19)Obese III
(N = 8)P Valuea,b Age, y, mean ± SD 50.36 ± 10.59 48.06 ± 8.03 52.32 ± 10.78 48.05 ± 10.35 0.502 Sex, % ( n ) 0.014 Female 54.1% (40) 18.5% (5) 36.8% (7) 37.5% (3) Male 46.0% (34) 81.5% (22) 63.2% (12) 62.5% (5) Smoking status, % (n) 0.294 Nonsmoker 82.4% (61) 92.6% (25) 94.7% (18) 75.0% (6) Smoker 17.6% (13) 7.4% (2) 5.3% (1) 25.0% (2) Insurance status, % (n) 0.062 Non-WC 81.1% (60) 55.6% (15) 66.7% (12) 62.5% (5) WC 18.9% (14) 44.4% (12) 33.3% (6) 37.5% (3) Diabetic status, % ( n ) 0.042 Nondiabetic 89.2% (66) 81.5% (66) 89.5% (17) 50.0% (4) Diabetic 10.8% (8) 8.5% (5) 10.5% (2) 50.0% (4) Ageless CCI, mean ± SD 0.66 ± 0.92 0.59 ± 0.50 0.78 ± 1.06 1.88 ± 1.73 0.007 Spinal diagnoses, % (n) Herniated nucleus pulposus 83.8% (62) 88.9% (24) 89.5% (17) 87.5% (7) 0.923 Degenerative disc disease 5.4% (4) 3.7% (1) 5.3% (1) 0.0% (0) 0.907 Foraminal stenosis 12.2% (9) 3.7% (1) 15.8% (3) 12.5% (1) 0.496 aP value was calculated for each category using multivariate linear regression (continuous) or either χ2 analysis or Fisher’s exact test (categorical).
bBoldface indicates statistical significance.
CCI, Charlson Comorbidity Index; SD, standard deviation; WC, workers’ compensation.
CharacteristicNonobese
(N = 74)Obese I
(N = 27)Obese II
(N = 19)Obese III
(N = 8)P Valuea Number of fusion levels, % (n) 0.816 1-Level 50.0% (37) 63.0% (17) 57.9% (11) 75.0% (6) 2-Level 36.5% (27) 29.6% (8) 36.8% (7) 25.0% (2) 3-Level 12.2% (9) 3.7% (1) 5.3% (1) 0.0% (0) 4-Level 1.4% (1) 3.7% (1) 0.0% (0) 0.0% (0) Operative time, min, mean ± SD 60.5 ± 16.2 55.1 ± 17.8 56.5 ± 16.0 62.3 ± 20.3 0.441 Estimated blood loss, mL,mean ± SD 29.5 ± 12.0 30.2 ± 13.0 32.9 ± 14.6 35.0 ± 21.9 0.578 Length of stay, h,mean ± SD 13.1 ± 12.1 11.4 ± 14.8 15.0 ± 10.6 11.4 ± 7.4 0.786 Discharge date, % (n) 0.081 POD 0 74.3% (55) 85.2% (23) 63.2% (12) 75.0% (6) POD 1 20.3% (15) 11.1% (3) 36.8% (7) 25.0% (2) POD 2 5.4% (4) 0.0% (0) 0.0% (0) 0.0% (0) POD 3+ 0.0% (0) 3.7% (1) 0.0% (0) 0.0% (0) aP value was calculated for each category using multivariate linear regression (continuous) or either χ2 analysis or Fisher’s exact test (categorical).
POD, postoperative day; SD, standard deviation.
Complication, % (n) Nonobese
(N = 74)Obese I
(N = 27)Obese II
(N = 19)Severe III
(N = 8)P Valuea Aspiration 0.0% (0) 0.0% (0) 0.0% (0) 0.0% (0) - Dysphagia 4.1% (3) 3.9% (1) 0.0% (0) 0.0% (0) 0.773 Urinary retention 0.0% (0) 0.0% (0) 5.3% (1) 0.0% (0) 0.126 Urinary tract infection 0.0% (0) 0.0% (0) 0.0% (0) 0.0% (0) - Acute renal failure 0.0% (0) 0.0% (0) 0.0% (0) 0.0% (0) - Postoperative anemia 0.0% (0) 0.0% (0) 0.0% (0) 0.0% (0) - Hematoma 1.3% (1) 3.9% (1) 0.0% (0) 0.0% (0) 0.724 Altered mental status 1.3% (1) 0.0% (0) 0.0% (0) 0.0% (0) 0.868 Venous thromboembolism 0.0% (0) 0.0% (0) 0.0% (0) 0.0% (0) - Pulmonary embolism 0.0% (0) 0.0% (0) 0.0% (0) 0.0% (0) - Pneumothorax 0.0% (0) 0.0% (0) 0.0% (0) 0.0% (0) - Arrhythmia 0.0% (0) 0.0% (0) 0.0% (0) 0.0% (0) - Pneumonia 0.0% (0) 0.0% (0) 0.0% (0) 0.0% (0) - Atelectasis 0.0% (0) 0.0% (0) 0.0% (0) 0.0% (0) - Pleural effusion 0.0% (0) 0.0% (0) 0.0% (0) 0.0% (0) - Fever (unknown origin) 0.0% (0) 0.0% (0) 0.0% (0) 0.0% (0) - Total complications 6.7% (5) 7.4% (2) 5.3% (1) 0.0% (0) 0.949 aP value was calculated for each category using Fisher’s exact test (categorical).
Dysphagia: 3 patients experienced dysphagia. 2 patients suffered from mild dysphagia and were able to tolerate general diet by discharge on POD1. 1 patient experienced dysphagia and increased neck swelling on POD0 due to a hematoma. Patient underwent an incision and drainage and symptoms resolved by POD1. Patient was discharged in stable condition on POD2. Urinary retention: 1 patient had postoperative urinary retention on POD0 with a postvoid residual volume >500 mL. Foley was placed on POD0. Patient placed on Flomax and voided by discharge on POD1. Hematoma: 2 patients had a cervical hematoma on POD0 and underwent an emergent incision and drainage, which resolved symptoms. 1 patient was safely discharged to home on POD3 and another patient was discharged safely home on POD2. No other complications were noted. Altered mental status: 1 patient was unresponsive on POD0 and received Narcan. Neurology consult placed on POD1 with unremarkable findings. Patient discharged to home safely on POD2. POD, postoperative day.
Outcome Mean ± SD (n) R 2 P Valuea Nonobese
(N = 74)Obese I
(N = 27)Obese II
(N = 19)Obese III
(N = 8)PROMIS-PF Preoperative 40.7 ± 6.6 (74) 38.6 ± 8.8 (27) 38.6 ± 5.7 (19) 39.4 ± 7.8 (8) 0.021 0.458 6 wk 42.5 ± 6.6 (53) 39.6 ± 7.9 (17) 39.2 ± 7.4 (15) 39.3 ± 6.7 (7) 0.048 0.220 12 wk 45.3 ± 8.7 (47) 49.7 ± 13.0 (15) 40.8 ± 5.5 (13) 43.9 ± 13.5 (4) 0.077 0.109 6 mo 47.9 ± 9.1 (41) 51.7 ± 11.3 (11) 41.1 ± 6.7 (11) 44.5 ± 7.3 (3) 0.114 0.060 1 y 50.5 ± 7.8 (35) 50.8 ± 9.5 (10) 43.0 ± 6.5 (8) 42.2 ± 6.9 (4) 0.149 0.035 2 y 51.3 ± 7.9 (25) 45.5 ± 9.1 (10) 41.7 ± 5.0 (9) 42.5 ± 13.1 (6) 0.205 0.014 PROMIS-PF 6 wk Δ 2.2 ± 6.5 -0.93 ± 10.0 0.35 ± 7.5 0.24 ± 10.0 0.027 0.476 12 wk Δ 4.1 ± 7.6 10.1 ± 10.4 1.8 ± 7.3 4.3 ± 7.3 0.101 0.044 6 mo Δ 7.3 ± 6.8 9.8 ± 9.3 4.2 ± 5.3 7.5 ± 7.6 0.053 0.331 1 year Δ 9.0 ± 8.0 10.5 ± 10.9 4.9 ± 5.0 5.0 ± 5.0 0.055 0.388 2 year Δ 9.9 ± 7.0 7.1 ± 8.5 2.3 ± 5.5 3.0 ± 11.7 0.156 0.048 aP value was calculated using linear regression (continuous) to compare each time point among subgroups.
BMI, body mass index; PROMIS-PF, Patient Reported Outcome Measurement Information System physical function.
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