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Incidence and Risk Factors of Gastrointestinal and Hepatobiliary Complications after Spinal Fusion Surgery: a Retrospective Cohort Study
- Source :
- Journal of Korean Medical Science
- Publication Year :
- 2020
- Publisher :
- Korean Academy of Medical Sciences, 2020.
-
Abstract
- Background Spinal surgery holds a higher chance of unpredicted postoperative medical complications among orthopedic surgeries. Several studies have analyzed the risk factors for diverse postoperative medical complications, but the majority investigated incidences of each complication qualitatively. Among gastrointestinal complications, reports regarding postoperative ileus were relatively frequent. However, risk factors or incidences of hepatobiliary complications have yet to be investigated. The purpose of this study was to examine the incidence of gastrointestinal complications after spinal surgery, quantitatively analyze the risk factors of frequent complications, and to determine cues requiring early approaches. Methods In total, 234 consecutive patients who underwent spinal fusion surgery performed by one senior doctor at our institute in one-year period were retrospectively enrolled for analyses. The primary outcomes were presence of paralytic ileus, elevated serum alanine transaminase (ALT) and aspartate transaminase (AST) levels, and elevated total bilirubin levels. Univariate logistic regression analyses of all variables were performed. In turn, significant results were reanalyzed by multivariate logistic regression. The variables used were adjusted with age and gender. Results Gastrointestinal complications were observed in 15.8% of patients. Upon the risk factors of postoperative ileus, duration of anesthesia (odds ratio [OR], 1.373; P = 0.015), number of fused segments (OR, 1.202; P = 0.047), and hepatobiliary diseases (OR, 2.976; P = 0.029) were significantly different. For elevated liver enzymes, men (OR, 2.717; P = 0.003), number of fused segments (OR, 1.234; P = 0.033), and underlying hepatobiliary (OR, 2.704; P = 0.031) and rheumatoid diseases (OR, 5.021; P = 0.012) had significantly different results. Lastly, risk factors for total bilirubin elevation were: duration of anesthesia (OR, 1.431; P = 0.008), number of fused segments (OR, 1.359; P = 0.001), underlying hepatobiliary diseases (OR, 3.426; P = 0.014), and thoracolumbar junction involving fusions (OR, 4.134; P = 0.002) compared to lumbar spine limited fusions. Conclusion Patients on postoperative care after spinal surgery should receive direct attention as soon as possible after manifesting abdominal symptoms. Laboratory and radiologic results must be carefully reviewed, and early consultation to gastroenterologists or general surgeons is recommended to avoid preventable complications.<br />Graphical Abstract
- Subjects :
- Male
medicine.medical_specialty
Biliary Tract Diseases
Digestive System Diseases
medicine.medical_treatment
Aspartate transaminase
03 medical and health sciences
Ileus
Postoperative Complications
0302 clinical medicine
Risk Factors
Internal medicine
Odds Ratio
Humans
Medicine
Anesthesia
Aspartate Aminotransferases
030212 general & internal medicine
Aged
Retrospective Studies
Lumbar Vertebrae
biology
business.industry
Liver Diseases
Incidence
Incidence (epidemiology)
Musculoskeletal Disorders, Rehabilitation & Sports Medicine
Alanine Transaminase
Bilirubin
Retrospective cohort study
General Medicine
Odds ratio
Middle Aged
Logistic Models
Spinal Fusion
Alanine transaminase
Spinal fusion
Orthopedic surgery
biology.protein
Female
Original Article
business
Complication
Subjects
Details
- ISSN :
- 15986357 and 10118934
- Volume :
- 35
- Database :
- OpenAIRE
- Journal :
- Journal of Korean Medical Science
- Accession number :
- edsair.doi.dedup.....e549577a9cbe77bc3e1a65ec4f7bebdf