Bariatric Surgery Before Elective Anterior Cervical Discectomy and Fusion (ACDF) in Obese Patients Is Associated With Reduced Risk of 90-Day Postoperative Complications and Readmissions.

Abstract:

STUDY DESIGN:This was a national database study. OBJECTIVE:The objective of this study was to assess the impact of prior bariatric surgery (BS) on altering 90-day postoperative outcomes following elective anterior cervical discectomy and fusions (ACDFs). SUMMARY OF BACKGROUND DATA:Though obesity has previously been shown to be linked with adverse outcomes following elective spine surgical procedures, the effectiveness of weight-loss strategies such as BS has not been explored. METHODS:The PearlDiver program was used to query the 2007-2013 100% Medicare Standard Analytical Files (SAF100) for patients undergoing an elective ACDF. The study cohort was divided into 2 groups-(1) obese ACDF patients (body mass index ≥35 kg/m) receiving a BS procedure within 2 years before an ACDF and (2) obese ACDF patients (body mass index ≥35 kg/m) without a known history of a BS procedure within the last 2 years. Multivariate regression analyses were used to assess the impact of a BS procedure on postoperative outcomes following ACDF while adjusting for age, sex, region, and Elixhauser Comorbidity Index. RESULTS:A total of 411 ACDF patients underwent BS within the 2 years before an ACDF. Multivariate analysis showed that undergoing BS before an elective ACDF was associated with a significantly reduced risk of pulmonary complications [odds ratio (OR)=0.53; P=0.002], cardiac complications (OR=0.69; P=0.012), sepsis (OR=0.69; P=0.035), renal complications (OR=0.54; P=0.044), and 90-day readmissions (OR=0.53; P=0.015). CONCLUSIONS:Surgery-induced weight loss before an ACDF in obese patients is associated with reduced 90-day complication and readmission rates. Orthopaedic and bariatric surgeons should counsel obese patients on the benefits of BS following ACDFs.

journal_name

Clin Spine Surg

journal_title

Clinical spine surgery

authors

Malik AT,Noria S,Xu W,Retchin S,Yu ES,Khan SN

doi

10.1097/BSD.0000000000001120

subject

Has Abstract

pub_date

2020-12-07 00:00:00

eissn

2380-0186

issn

2380-0194

pub_type

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