A new study published in Clinical Spine Surgery examines the factors that can predict postoperative morbidity and readmissions for posterior lumbar fusion.
The study authors examined the American College of Surgeons National Surgical Quality Improvement Program database to identify patients who underwent revision posterior lumbar fusion from 2005 to 2013. The study authors found:
1. There were 1,287 patients included in the study and 8.2 percent had adverse events; 5.6 percent were severe and 3.2 percent were minor.
2. Factors associated with adverse events include:
• ASA Class III or more
• Operating time of 310 minutes or more
3. The only factor associated with severe adverse events was an ASA Class III or more. Factors associated with a minor adverse event were insulin-dependent diabetes, operative time of 310 minutes or more and three or more level fusion.
4. Around 65 percent of the patients were readmitted. Factors associated with readmission include:
• BMI of 25 or above
• ASA Class III or more
• Insulin-dependent diabetes
• Two-level fusions
• Three or more levels fused
5. The study authors concluded, "In general, longer, more extensive procedures on sicker patients were associated with increased risk of postoperative complications and readmission."