The relationship between diabetes and the reoperation rate after lumbar spinal surgery: a nationwide cohort study
| Autor: | Byung Joo Park, Bo-ram Choi, Chun Kee Chung, Sukyoun Shin, Min Jung Kim, Chi Heon Kim, Yunhee Choi |
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| Rok vydání: | 2014 |
| Předmět: |
Adult
Male Reoperation medicine.medical_specialty Decompression Context (language use) Cohort Studies Lumbar Risk Factors Diabetes mellitus Outcome Assessment Health Care medicine Diabetes Mellitus Humans Orthopedics and Sports Medicine Aged Retrospective Studies Aged 80 and over business.industry Incidence (epidemiology) Incidence Lumbosacral Region Retrospective cohort study Middle Aged medicine.disease Decompression Surgical United States Surgery Spinal Fusion Anesthesia Cohort Female Neurology (clinical) business Cohort study |
| Zdroj: | The spine journal : official journal of the North American Spine Society. 15(5) |
| ISSN: | 1878-1632 |
| Popis: | Background context Diabetes is present in 5% to 20% of patients undergoing spine surgeries and is a known risk factor for reoperation. Considering the chronicity of diabetes, its influence on the reoperation rate may differ over time. Purpose To present the relationship between diabetes and the reoperation rate over time. Study design/setting Retrospective cohort study. Patient sample A national health insurance database was used to identify a cohort of patients who underwent an initial surgery for lumbar degenerative disease in 2003 (n=34,918). Outcome measures The primary end point was any type of second lumbar surgery after fusion surgery (n=4,792) or decompression surgery (n=30,126) during the early (0–postoperative 90 days), short-term (91–365 days), and midterm (1–6 years) periods. Methods All patients were followed up until December 2008. Cox proportional hazards regression modeling was used to assess the adjusted reoperation rates in the diabetic patients. Results The incidence of diabetes in the present cohort was 24.5% in the fusion group and 16.9% in the decompression group. Overall, reoperation was performed in 13.2% (631 of 4,792) of the patients after fusion surgery and in 14.0% (4,214 of 30,126) of the patients after decompression surgery. After fusion surgery, diabetes did not make a significant difference in the reoperation rate during the entire follow-up period. After decompression surgery, the reoperation rate was not different during Postoperative Month 3, but diabetic patients showed a 1.2 to 1.4 times higher reoperation rate during postoperative 3 months to 5 years (p Conclusions The study did not find a relationship between diabetes at the time of surgery and the reoperation rate during the early postoperative period. Thereafter, the reoperation rate was not higher after fusion surgery in diabetic patients, but it was higher after decompression surgery. |
| Databáze: | OpenAIRE |
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