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Research ArticleLumbar Spine

Modifiable Patient Factors Demonstrate No Increased Risk for 30-Day Complication Rate for Elective 1-2 Level Posterior Lumbar Fusion Surgery: A Comparison Between a National Database and Local Registry

Cameron Kia, Aris Yannopoulos, Sagar Gulati, Michael Cremins, Mark Cote and Isaac Moss
International Journal of Spine Surgery August 2022, 16 (4) 727-734; DOI: https://doi.org/10.14444/8296
Cameron Kia
1 Department of Orthopaedics, University of Connecticut Health Center, Farmington, CT, USA
MD
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Aris Yannopoulos
2 Department of Orthopaedics, Saint Francis Hospital and Medical Center, Hartford, CT, USA
3 Musculoskeletal Outcomes Institute, Saint Francis Hospital and Medical Center, Hartford, CT, USA
MD
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Sagar Gulati
1 Department of Orthopaedics, University of Connecticut Health Center, Farmington, CT, USA
BS
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Michael Cremins
3 Musculoskeletal Outcomes Institute, Saint Francis Hospital and Medical Center, Hartford, CT, USA
PA-C, PhD
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Mark Cote
1 Department of Orthopaedics, University of Connecticut Health Center, Farmington, CT, USA
PT, DPT, MS, CTR
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Isaac Moss
1 Department of Orthopaedics, University of Connecticut Health Center, Farmington, CT, USA
MD, MASc, FRCSC
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  • Figure 1
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    Figure 1

    Flow diagram of patients included for analysis between database cohorts. ACS NSQIP, American College of Surgeons National Surgical Quality Improvement Program.

  • Figure 2
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    Figure 2

    Demonstrates the incidence of patient comorbidities between the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database and institutional registry. CHF, congestive heart failure; HTN, hypertension, COPD, chronic obstructive pulmonary disease.

  • Figure 3
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    Figure 3

    Demonstrates the relative risk (American College of Surgeons National Surgical Quality Improvement Program [ACS NSQIP]/institutional registry) of each adverse event. Error bars indicate CI, and * denotes P < 0.05. CHF, congestive heart failure; HTN, hypertension, COPD, chronic obstructive pulmonary disease.

  • Figure 4
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    Figure 4

    Demonstrates the incidence of 30-day adverse events between the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database and institutional registry. UTI, urinary tract infection.

  • Figure 5
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    Figure 5

    Demonstrates the relative risk (American College of Surgeons National Surgical Quality Improvement Program [AC NSQIP]/institutional registry) of each adverse event. Error bars indicate CI, and * denotes P < 0.05. UTI, urinary tract infection.

Tables

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    Table 1

    Patient demographic characteristics between the national database and institutional cohort.

    American College of Surgeons National Surgical Quality Improvement Program (N = 13,678)Institutional Registry (N = 940) P Value
    Age, y   
     18–302.2%2.0% 
     31–5017.1%22.1%a  
     51–6539.4%42.7% 
     >6541.3%33.2%a < 0.001
    Sex   
     Male46.0%44.8% 
     Female54.0%55.2%0.32
    Body mass index31.1729.73< 0.001
    ASA classification   
     12.7%2.1% 
     247.8%74.9%a  
     347.9%22.8%a  
     41.8%0.2%a < 0.001
    Levels fused   
     176.1%82.9% 
     223.9%17.1% < 0.001
    • Abbreviation: ASA, American Society of Anesthesiologists.

    • View popup
    Table 2

    Relative risk of comorbidity on adverse event between data sources.

    Institutional Registry
     
    Institutional RegistryAmerican College of Surgeons National Surgical Quality Improvement Program
    Relative Risk P Value95% CIRelative Risk P Value95% CI
    Age1.03< 0.0011.01–1.051.01< 0.0011.01–1.02
    Sex
    Female1.790.011.13–2.861.34< 0.0011.18–1.53
    2-Level fusion1.150.620.66–1.981.150.041.01–1.32
    Obesity0.910.680.58–1.411.33< 0.0011.18–1.52
    Smoking0.920.810.46–1.831.220.021.04–1.44
    Congestive heart failure1.980.370.45–8.741.130.760.50–2.56
    Chronic obstructive pulmonary disease1.530.340.63–3.711.140.320.88–1.46
    Hypertension0.830.430.52–1.321.210.011.05–1.39
    • a P < 0.05.

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Modifiable Patient Factors Demonstrate No Increased Risk for 30-Day Complication Rate for Elective 1-2 Level Posterior Lumbar Fusion Surgery: A Comparison Between a National Database and Local Registry
Cameron Kia, Aris Yannopoulos, Sagar Gulati, Michael Cremins, Mark Cote, Isaac Moss
International Journal of Spine Surgery Aug 2022, 16 (4) 727-734; DOI: 10.14444/8296

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Modifiable Patient Factors Demonstrate No Increased Risk for 30-Day Complication Rate for Elective 1-2 Level Posterior Lumbar Fusion Surgery: A Comparison Between a National Database and Local Registry
Cameron Kia, Aris Yannopoulos, Sagar Gulati, Michael Cremins, Mark Cote, Isaac Moss
International Journal of Spine Surgery Aug 2022, 16 (4) 727-734; DOI: 10.14444/8296
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Keywords

  • clinical outcomes
  • lumbar
  • NSQIP
  • adverse events
  • database outcomes
  • posterior spinal fusion
  • adult
  • institutional registry
  • fusion

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