Risk Factors for Postoperative Ileus after Scoliosis Surgery

Abstract

Introduction: One complication after scoliosis surgery is ileus; however, few reports have described the frequency of and risk factors for this complication. We conducted a retrospective clinical study with logistic regression analysis to confirm the frequency of and risk factors for ileus after scoliosis surgery. Methods: After a retrospective review of data from patients who underwent surgical correction of spinal deformity from 2009 to 2014, 110 cases (age range, 4-73 yr; median, 14 yr) were included in the study. We defined postoperative ileus (POI) as a surgical complication characterized by decreased intestinal peristalsis and the absence of stool for more than 3 days postoperatively. Various parameters were compared between patients with POI and those without POI. Logistic regression analysis was performed to assess the risk factors associated with ileus; a P value of <0.05 was considered statistically significant. Results: Fifteen of 110 (13.6%) cases developed POI. The median height, weight, operation time, and blood loss volume of the patients with versus without POI were 146 versus 152 cm, 39.0 versus 44.0 kg, 387 versus 359 min, and 1590 versus 1170 g, respectively. There were no significant differences between patients with versus without POI in the measured parameters, with the exception of patient height, bed rest period, and presence of neuromuscular scoliosis. Multiple logistic regression analysis revealed neuromuscular scoliosis as a significant risk factor for POI (odds ratio, 4.21; 95% CI, 1.23-14.40). Conclusions: Our findings indicate a high probability of POI after scoliosis surgery, with an incidence of 13.6%. Neurogenic scoliosis, but not lowest instrumented vertebra or correction rate, was a risk factor for POI after scoliosis surgery. Digestive symptoms should be carefully monitored after surgery, particularly in patients with neuromuscular scoliosis.

Clinical Importance, Incidence and Risk Factors for the Development of Postoperative Ileus Following Adult Spinal Deformity Surgery

“… 10 , 17 , 18 In particular, ASD surgery has many risk factors that have been reported for POI development, such as use of an anterior approach, surgery in the prone position, scoliosis surgery and intraoperative opioid exposure. 10 , 11 , 19 - 21 A recent study reported a high incidence (18.4%) of POI, and length of stay remains significantly longer in patients who develop POI after adult spinal surgery. 22 However, there was insufficient evidence regarding the risk of development of POI after ASD surgery and the changes in spinal alignment caused by spinal corrective surgery.…”

What Are Risk Factors for an Ileus After Posterior Spine Surgery?—A Case Control Study

“…The majority of studies analyzing risk factors for a postoperative ileus were able to show that surgical factors such as duration of surgery, selected approach and blood loss might be an important factor in the development of a postoperative ileus. 21,22 Our study did show significant differences between the 2 groups in the length of stay, lumbar surgery and major spine surgery (> 3 level). These results are in line with the study reported by Fineberg et al which identified 7,741 cases of postoperative ileus out of 220 522 lumbar fusions using the NIS (Nationwide Inpatient Sample) data.…”

Preoperative Base Excess as a Predictor of Perioperative Complications in Patients with Nonidiopathic Scoliosis who Have High Risk Associated with General Anesthesia

“…Ileus was the second most common complication in the current study, but few reports have described this complication. One retrospective study showed that ileus after scoliosis surgery occurred in 13.6% of patients 28) . Another study showed that paralytic ileus occurred in 6.0% of patients with neuromuscular scoliosis 29) .…”