Perioperative Complications Associated with Severity of Anemia in Geriatric Patients Undergoing Spinal Procedures
| Autor: | Neil R. Parekh, Daniel E. Bestourous, Ryan Lee, Neil D. Almeida, Kenneth Sack, Jonathan H. Sherman, Andrea L. Klein |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Male
Reoperation medicine.medical_specialty Anemia Urinary system Hematocrit 03 medical and health sciences 0302 clinical medicine Postoperative Complications Risk Factors hemic and lymphatic diseases Internal medicine medicine Humans Risk factor Perioperative Period Aged Geriatrics medicine.diagnostic_test business.industry Wound dehiscence Perioperative Odds ratio Middle Aged medicine.disease Spine Elective Surgical Procedures 030220 oncology & carcinogenesis Urinary Tract Infections Quality of Life Surgery Female Neurology (clinical) business 030217 neurology & neurosurgery |
| Zdroj: | World neurosurgery. 135 |
| ISSN: | 1878-8769 |
| Popis: | Objective To investigate preoperative baseline anemia, stratified by severity as a function of hematocrit level, as a risk factor for perioperative complications in geriatric patients undergoing spinal procedures. Background Previous literature has examined the impact of anemia on risk for complications and adverse outcomes in patients undergoing elective spinal procedures. However, there is a paucity of literature analyzing the impact of anemia in the geriatric population, specifically. Methods The American College of Surgeons–National Surgical Quality Improvement Database was used to identify patients older than 65 years who had undergone elective spinal procedures and were subsequently stratified into 3 separate cohorts based on hematocrit levels: severe/moderate (hematocrit level 38%). These patient samples were then analyzed using multivariate analyses to assess severity of anemia as a risk factor for complications in elderly patients undergoing spinal procedures. Results When anemia classes were analyzed as separate independent risk factors for complications, mild anemia (class II) was a significant risk factor for the same complications as moderate/severe anemia (class III/IV), with the exception of 2 complications, compared with nonanemic patients. Mild anemia was independently associated with wound dehiscence (odds ratio, 1.521; 95% confidence interval, 1.126–2.054; P = 0.006), whereas moderate/severe anemia did not show an increased risk for wound dehiscence. However, moderate/severe anemia independently increased the risk for deep venous thromboembolism (odds ratio, 1.437; 95% confidence interval, 1.028–2.011; P = 0.034), compared with mild anemia. Both categories of anemia independently increased the risk for additional complications such as deep incisional surgical site infection, organ/space surgical site infection, pneumonia, unplanned intubation, ventilator dependence, progressive renal insufficiency, acute renal failure, urinary tract infections, cardiac arrest, myocardial infarctions, blood transfusions, systemic sepsis, reoperation, extended length of stay of ≥5 days, unplanned readmission, and mortality. Conclusions This study indicated that patients with preoperative baseline anemia were at risk for requiring transfusions, renal failure, and infectious complications. Physicians should be cognizant of anemia as a risk factor affecting numerous perioperative complications and adverse outcomes to work toward improving health-related quality of life. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect