Impact of Metabolic Syndrome on Early Postoperative Outcomes After Cervical Disk Replacement: A Propensity-matched Analysis.

Autor:	Zhao E; Hospital for Special Surgery.; Weill Cornell Medicine, New York, NY., Shinn DJ; Hospital for Special Surgery.; Weill Cornell Medicine, New York, NY., Basilious M; Weill Cornell Medicine, New York, NY., Subramanian T; Hospital for Special Surgery.; Weill Cornell Medicine, New York, NY., Shahi P; Hospital for Special Surgery., Amen TB; Hospital for Special Surgery., Maayan O; Hospital for Special Surgery.; Weill Cornell Medicine, New York, NY., Dalal S; Hospital for Special Surgery., Araghi K; Hospital for Special Surgery., Song J; Hospital for Special Surgery., Sheha ED; Hospital for Special Surgery., Dowdell JE; Hospital for Special Surgery., Iyer S; Hospital for Special Surgery., Qureshi SA; Hospital for Special Surgery.
Jazyk:	angličtina
Zdroj:	Clinical spine surgery [Clin Spine Surg] 2024 Jun 01; Vol. 37 (5), pp. E185-E191. Date of Electronic Publication: 2024 Feb 05.
DOI:	10.1097/BSD.0000000000001567
Abstrakt:	Study Design: Retrospective cohort study. Objective: To compare the demographics, perioperative variables, and complication rates following cervical disk replacement (CDR) among patients with and without metabolic syndrome (MetS). Summary of Background Data: The prevalence of MetS-involving concurrent obesity, insulin resistance, hypertension, and hyperlipidemia-has increased in the United States over the last 2 decades. Little is known about the impact of MetS on early postoperative outcomes and complications following CDR. Methods: The 2005-2020 National Surgical Quality Improvement Program was queried for patients who underwent primary 1- or 2-level CDR. Patients with and without MetS were divided into 2 cohorts. MetS was defined, according to other National Surgical Quality Improvement Program studies, as concurrent diabetes mellitus, hypertension requiring medication, and body mass index ≥30 kg/m 2 . Rates of 30-day readmission, reoperation, complications, length of hospital stay, and discharge disposition were compared using χ 2 and Fisher exact tests. One to 2 propensity-matching was performed, matching for demographics, comorbidities, and number of operative levels. Results: A total of 5395 patients were included for unmatched analysis. Two hundred thirty-six had MetS, and 5159 did not. The MetS cohort had greater rates of 30-day readmission (2.5% vs. 0.9%; P =0.023), morbidity (2.5% vs. 0.9%; P =0.032), nonhome discharges (3% vs. 0.6%; P =0.002), and longer hospital stays (1.35±4.04 vs. 1±1.48 days; P =0.029). After propensity-matching, 699 patients were included. All differences reported above lost significance ( P >0.05) except for 30-day morbidity (superficial wound infections), which remained higher for the MetS cohort (2.5% vs. 0.4%, P =0.02). Conclusions: We identified MetS as an independent predictor of 30-day morbidity in the form of superficial wound infections following single-level CDR. Although MetS patients experienced greater rates of 30-day readmission, nonhome discharge, and longer lengths of stay, MetS did not independently predict these outcomes after controlling for baseline differences in patient characteristics. Level of Evidence: Level III. Competing Interests: The authors declare no conflict of interest. (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
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