A new study published in Spine examines the impact of renal impairment on morbidity after lumbar spine surgery.
The study is a large, multicenter, clinical registry that gathered data on lumbar spine surgery patients in 2012. There were 13,576 cases included in the study. The researchers found:
1. The morbidity risk increased with a worsening estimated glomerular filtration rate in the inverse-logarithmic fashion. The risk magnitude increased substantially for patients with eGRF below 60.
2. There was a 26 percent relative increase in morbidity in moderate to severe renal impairment patients. This is compared with the propensity score—matched cohort of patients with no or mild disease.
3. The wound complication rates were higher in patients with moderate or severe disease, 3 percent versus 2.1 percent.
4. Reoperation rates were higher — 4.6 percent — in the patients with moderate or severe disease than the patients without — 3.3 percent.
5. Blood transfusions were higher — 16.3 percent — among patients with moderate or severe disease, as compared with patients who didn’t have disease — 12.8 percent.
6. The patients with a preoperative moderate or severe renal impairment were 10 times more likely to develop acute renal failure after surgery, according to the report.
The researchers concluded the 30-day morbidity risk after lumbar spine surgery was strongly associated with renal impairment. “These data may be useful for preoperative patient counseling and patients with severe renal disease, particularly in elective cases,” concluded the study authors.