PMID- 34352887
OWN - NLM
STAT- MEDLINE
DCOM- 20211223
LR  - 20221207
IS  - 1524-4040 (Electronic)
IS  - 0148-396X (Linking)
VI  - 89
IP  - 5
DP  - 2021 Oct 13
TI  - Preoperative HbA1c > 8% Is Associated With Poor Outcomes in Lumbar Spine Surgery: 
      A Michigan Spine Surgery Improvement Collaborative Study.
PG  - 819-826
LID - 10.1093/neuros/nyab294 [doi]
AB  - BACKGROUND: Preoperative hemoglobin A1c (HbA1c) is a useful screening tool since 
      a significant portion of diabetic patients in the United States are undiagnosed 
      and the prevalence of diabetes continues to increase. However, there is a paucity 
      of literature analyzing comprehensive association between HbA1c and postoperative 
      outcome in lumbar spine surgery. OBJECTIVE: To assess the prognostic value of 
      preoperative HbA1c > 8% in patients undergoing elective lumbar spine surgery. 
      METHODS: The Michigan Spine Surgery Improvement Collaborative (MSSIC) database 
      was queried to track all elective lumbar spine surgeries between January 2018 and 
      December 2019. Cases were divided into 2 cohorts based on preoperative HbA1c 
      level (</=8% and >8%). Measured outcomes include any complication, surgical site 
      infection (SSI), readmission (RA) within 30 d (30RA) and 90 d (90RA) of index 
      operation, patient satisfaction, and the percentage of patients who achieved 
      minimum clinically important difference (MCID) using Patient-Reported Outcomes 
      Measurement Information System. RESULTS: We captured 4778 patients in this study. 
      Our multivariate analysis demonstrated that patients with HbA1c > 8% were more 
      likely to experience postoperative complication (odds ratio [OR] 1.81, 95% CI 
      1.20-2.73; P = .005) and be readmitted within 90 d of index surgery (OR 1.66, 95% 
      CI 1.08-2.54; P = .021). They also had longer hospital stay (OR 1.12, 95% CI 
      1.03-1.23; P = .009) and were less likely to achieve functional improvement after 
      surgery (OR 0.64, 95% CI 0.44-0.92; P = .016). CONCLUSION: HbA1c > 8% is a 
      reliable predictor of poor outcome in elective lumbar spine surgery. Clinicians 
      should consider specialty consultation to optimize patients' glycemic control 
      prior to surgery.
CI  - (c) Congress of Neurological Surgeons 2021.
FAU - Lim, Seokchun
AU  - Lim S
AD  - Department of Neurological Surgery, Henry Ford Hospital, Detroit, Michigan, USA.
FAU - Yeh, Hsueh-Han
AU  - Yeh HH
AD  - Department of Public Health Services, Henry Ford Hospital, Detroit, Michigan, 
      USA.
FAU - Macki, Mohamed
AU  - Macki M
AD  - Department of Neurological Surgery, Henry Ford Hospital, Detroit, Michigan, USA.
FAU - Mansour, Tarek
AU  - Mansour T
AD  - Department of Neurological Surgery, Henry Ford Hospital, Detroit, Michigan, USA.
FAU - Schultz, Lonni
AU  - Schultz L
AD  - Department of Neurological Surgery, Henry Ford Hospital, Detroit, Michigan, USA.
AD  - Department of Public Health Services, Henry Ford Hospital, Detroit, Michigan, 
      USA.
FAU - Telemi, Edvin
AU  - Telemi E
AD  - Department of Neurological Surgery, Henry Ford Hospital, Detroit, Michigan, USA.
FAU - Haider, Sameah
AU  - Haider S
AD  - Department of Neurological Surgery, Henry Ford Hospital, Detroit, Michigan, USA.
FAU - Nerenz, David R
AU  - Nerenz DR
AD  - Department of Neurological Surgery, Henry Ford Hospital, Detroit, Michigan, USA.
AD  - Center for Health Services Research, Henry Ford Hospital, Detroit, Michigan, USA.
FAU - Schwalb, Jason M
AU  - Schwalb JM
AD  - Department of Neurological Surgery, Henry Ford Hospital, Detroit, Michigan, USA.
FAU - Abdulhak, Muwaffak
AU  - Abdulhak M
AD  - Department of Neurological Surgery, Henry Ford Hospital, Detroit, Michigan, USA.
FAU - Park, Paul
AU  - Park P
AD  - Department of Neurosurgery, University of Michigan, Ann Arbor, Michigan, USA.
FAU - Aleem, Ilyas
AU  - Aleem I
AD  - Department of Orthopedics, University of Michigan, Ann Arbor, Michigan, USA.
FAU - Easton, Richard
AU  - Easton R
AD  - Department of Orthopedics, William Beaumont Hospital, Troy, Michigan, USA.
FAU - Khalil, Jad
AU  - Khalil J
AD  - Department of Orthopedics, William Beaumont Hospital, Royal Oak, Michigan, USA.
FAU - Perez-Cruet, Miguelangelo
AU  - Perez-Cruet M
AD  - Department of Neurosurgery, William Beaumont Hospital, Royal Oak, Michigan, USA.
FAU - Chang, Victor
AU  - Chang V
AUID- ORCID: 0000-0002-8580-0706
AD  - Department of Neurological Surgery, Henry Ford Hospital, Detroit, Michigan, USA.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Neurosurgery
JT  - Neurosurgery
JID - 7802914
RN  - 0 (Glycated Hemoglobin A)
SB  - IM
CIN - Neurosurgery. 2021 Nov 18;89(6):E308-E309. PMID: 34432019
MH  - Elective Surgical Procedures
MH  - Glycated Hemoglobin
MH  - Humans
MH  - Lumbar Vertebrae/surgery
MH  - Michigan/epidemiology
MH  - Neurosurgical Procedures
MH  - Postoperative Complications/epidemiology
MH  - *Spinal Fusion
MH  - United States
OTO - NOTNLM
OT  - Diabetes
OT  - HbA1c
OT  - Lumbar spine surgery
OT  - MSSIC
OT  - Outcome
EDAT- 2021/08/06 06:00
MHDA- 2021/12/24 06:00
CRDT- 2021/08/05 20:37
PHST- 2020/12/08 00:00 [received]
PHST- 2021/06/07 00:00 [accepted]
PHST- 2021/08/06 06:00 [pubmed]
PHST- 2021/12/24 06:00 [medline]
PHST- 2021/08/05 20:37 [entrez]
AID - 6342534 [pii]
AID - 10.1093/neuros/nyab294 [doi]
PST - ppublish
SO  - Neurosurgery. 2021 Oct 13;89(5):819-826. doi: 10.1093/neuros/nyab294.