Incidence and Risk Factors for Pneumonia After Posterior Lumbar Fusion Procedures

Bohl, Daniel D.; Mayo, Benjamin C.; Massel, Dustin H.; Iantorno, Stephanie E.; Ahn, Junyoung; Basques, Bryce A.; Grauer, Jonathan N.; Singh, Kern

doi:10.1097/brs.0000000000001389

Cited by 38 publications

(37 citation statements)

References 21 publications

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“…Bohl et al [51] retrospectively reviewed 11,353 patients who underwent anterior cervical decompression and fusion, and found postoperative pneumonia had an incidence rate of 0.45%. Another retrospective study by Bohl et al [52] looked at 12,428 posterior lumber fusion patients who had a postoperative pneumonia incidence of 0.59%.…”

Section: Resultsmentioning

confidence: 99%

“…Bohl et al [51] identified independent risk factors as greater age (relative risk (RR) for age 50 - 59 years: 2.6; 95% CI: 1.0 - 7.2; RR for age 60 - 69 years: 4.3; 95% CI: 1.6 - 11.7; RR for age ≥ 70 years: 9.5; 95% CI: 3.5 - 25.6; P < 0.001), dependent functional status (RR: 5.3; P < 0.001), COPD (RR: 4.4; 95% CI: 2.3 - 8.6; P < 0.001), and greater operative duration (RR for 100 - 149 min: 1.4; 95% CI: 0.7 - 3.0; RR for 150 - 199 min: 2.2; 95% CI: 1.0 - 4.9; RR for ≥ 200 min: 3.0; 95% CI: 1.5 - 6.4; P = 0.020). Another retrospective study by Bohl et al [52] identified COPD (RR: 2.7; P = 0.006), steroid use (RR: 2.6; P = 0.017), non-insulin-dependent diabetes mellitus (DM) (RR: 2.4; P = 0.003), insulin-dependent DM (RR: 2.9; P = 0.005), and greater number of operative procedure levels (two level: RR: 1.7, P = 0.033; three level: RR: 2.7, P = 0.007).…”

Section: Resultsmentioning

confidence: 99%

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The Epidemiology and Risk Factors for Postoperative Pneumonia

et al. 2017

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Postoperative pneumonia is a common complication of surgery, and is associated with marked morbidity and mortality. Despite advances in surgical and anesthetic technique, it persists as a frequent postoperative complication. Many studies have aimed to assess its burden, as well as associated risk factors. However, this complication varies among the different surgical specialties, and there is a paucity of reports that comprehensively evaluate this complication. Therefore, the purpose of this study was to review the epidemiology and risk factors of postoperative pneumonia in the setting of: 1) general surgery; 2) cardiothoracic surgery; 3) orthopedic and spine surgery; and 4) head and neck surgery.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

The Epidemiology and Risk Factors for Postoperative Pneumonia

et al. 2017

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“…Our result is in agreement with much of the spine literature, which has analyzed populations primarily consisting of mixed surgical cohorts. [17][18][19][20][21][22][23] Cook et al, 22 in a study of 37 322 patients undergoing cervical fusion from the Nationwide Inpatient Sample database, determined that the presence of diabetes was associated with increased complication incidence. Specifically, diabetic patients had a greater incidence of cardiac complications and non-home discharge.…”

Section: Discussionmentioning

confidence: 99%

“…The etiology of increased medical complications in diabetic patients has been theorized to result from diabetes-related impairments to the systemic inflammatory response. 18,23 Diabetic status has also been associated with longer lengths of inpatient stay, yielding an increase in risk for complications associated with exposure to nosocomial settings. [18][19][20]22,23 Recent literature has also suggested that uncontrolled diabetes may further increase the rate of complications compared to controlled diabetes, indicating a potential role for improved preoperative glycemic control measures in diabetic patients undergoing spinal surgery.…”

Section: Discussionmentioning

confidence: 99%

“…18,23 Diabetic status has also been associated with longer lengths of inpatient stay, yielding an increase in risk for complications associated with exposure to nosocomial settings. [18][19][20]22,23 Recent literature has also suggested that uncontrolled diabetes may further increase the rate of complications compared to controlled diabetes, indicating a potential role for improved preoperative glycemic control measures in diabetic patients undergoing spinal surgery. 20 Regarding surgical complications, age 50 years was associated with greater complication rate after MIS TLIF.…”

Section: Discussionmentioning

confidence: 99%

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Risk Factors for Medical and Surgical Complications After Single-Level Minimally Invasive Transforaminal Lumbar Interbody Fusion

et al. 2020

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Background: The prevention of perioperative and postoperative complications is necessary to avoid poor postoperative outcomes and increased costs. Previous investigations have identified risk factors for complications after various spine procedures, but no such study exists in a population solely undergoing minimally invasive transforaminal lumbar interbody fusion (MIS TLIF). The purpose of this study is to determine risk factors for the development of complications up to 2 years after MIS TLIF procedures. Methods: Patients who underwent primary, single-level MIS TLIF from 2007 to 2016 were retrospectively reviewed. The incidence of medical and surgical complications up to 2 years postoperatively was determined. Patients were categorized according to demographic, comorbidity, and procedural characteristics. Bivariate Poisson regression with robust error variance was used to determine if an association existed between patient characteristics and complication incidence. A final multivariate model including all patient characteristics as controls was created using backwards, stepwise regression until only those variables with P , .05 remained. Results: 390 patients were analyzed. Upon bivariate analysis, age .50 years (P ¼ .025), diabetes mellitus (P ¼ .001), and operative duration .105 minutes (P ¼ .016) were associated with increased medical complication rates. Regarding surgical complications, age 50 years (P , .001), obesity (P ¼ .012), and diabetes mellitus (P ¼ .042) were identified as risk factors on bivariate analysis. Upon final multivariate analysis, operative time .105 minutes (P ¼ .009) and diabetes mellitus (P ¼ .001) were independent risk factors for medical complications. Independent risk factors for surgical complications on multivariate analysis included age 50 years (P , .001), diabetes mellitus (P ¼ .002), and obesity (P ¼ .030). Conclusions: Diabetic patients and those who underwent longer operations were at increased risk of medical complications, while younger patients, obese patients and those also with diabetes mellitus were at increased risk of surgical complications up to 2 years after MIS TLIF. Practitioners can use this information to identify patients who require preventative care before their procedure or increased postoperative vigilance and monitoring after single-level MIS TLIF.

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Predicting the post-operative length of stay for the orthopaedic trauma patient

Chona

Lakomkin

Bulka

et al. 2017

International Orthopaedics (SICOT)

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Utilizing a large prospective cohort of orthopaedic trauma patients, we created the first personalized LOS calculator based on pre-operative comorbidities, post-operative complications and location of surgery. Future work may assess the use of this calculator and attempt to validate its utility as an accurate model. To improve the quality measures of hospitals, orthopaedists must employ such predictive tools to optimize care and better manage resources.

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Incidence and Risk Factors for Pneumonia After Posterior Lumbar Fusion Procedures

Abstract: 3.

Cited by 38 publications

References 21 publications

The Epidemiology and Risk Factors for Postoperative Pneumonia

The Epidemiology and Risk Factors for Postoperative Pneumonia

Risk Factors for Medical and Surgical Complications After Single-Level Minimally Invasive Transforaminal Lumbar Interbody Fusion

Predicting the post-operative length of stay for the orthopaedic trauma patient

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