PMID- 35659650
OWN - NLM
STAT- MEDLINE
DCOM- 20220608
LR  - 20220716
IS  - 1471-2474 (Electronic)
IS  - 1471-2474 (Linking)
VI  - 23
IP  - 1
DP  - 2022 Jun 4
TI  - Obesity and perioperative adverse events in patients undergoing complex revision 
      surgery for the thoracolumbar spine.
PG  - 534
LID - 10.1186/s12891-022-05505-4 [doi]
LID - 534
AB  - BACKGROUND: There are no previous studies that evaluate the effect of obesity on 
      patients undergoing complex revision thoracolumbar spine surgery. The primary 
      objective was to determine the relationship between obesity and perioperative 
      adverse events (AEs) with patients undergoing complex revision thoracolumbar 
      spine surgery while controlling for psoas muscle index (PMI) as a confounding 
      variable. The secondary objective was to determine the relationship between 
      obesity and 30-day readmission rates, 30-day re-operation rates, rate of 
      discharge to a facility, and post-operative length of stay (LOS). METHODS: 
      Between May 2016 and February 2020, a retrospective analysis of individuals 
      undergoing complex revision surgery of the thoracolumbar spine was performed at a 
      single institution. Obesity was defined as BMI >/= 30.0 kg/m(2). 
      PMI < 500 mm(2)/m(2) for males and < 412 mm(2)/m(2) for females were used to 
      define low muscle mass. A Spine Surgical Invasiveness Index (SSII) > 10 was used 
      to define complex revision surgery. A multivariable logistic regression model was 
      used to ascertain the effects of low muscle mass, obesity, age, and gender on the 
      likelihood of the occurrence of any AE. RESULTS: A total of 114 consecutive 
      patients were included in the study. Fifty-four patients were in the obese cohort 
      and 60 patients in the non-obese cohort. There was not a significant difference 
      in perioperative outcomes of both the obese and non-obese patients. There were 22 
      obese patients (40.7%) and 33 non-obese patients (55.0%) that experienced any AE 
      (p = 0.130). Multivariable analysis demonstrated that individuals with low muscle 
      mass had a significantly higher likelihood for an AE than individuals with normal 
      or high muscle mass (OR: 7.53, 95% CI: 3.05-18.60). Obesity did not have a 
      significant effect in predicting AEs. CONCLUSIONS: Obesity is not associated with 
      perioperative AEs, 30-day readmission rates, 30-day re-operation rates, rate of 
      discharge to a facility, or post-operative length of stay (LOS) among patients 
      undergoing complex revision thoracolumbar spine surgery. LEVEL OF EVIDENCE: III.
CI  - (c) 2022. The Author(s).
FAU - Hirase, Takashi
AU  - Hirase T
AD  - Department of Orthopedics and Sports Medicine, Houston Methodist Hospital, 6445 
      Main St Suite 2500, Houston, TX, 77030, USA. thirase@houstonmethodist.org.
AD  - Texas A&M University Health Science Center College of Medicine, 8447 Riverside 
      Pkwy, Bryan, TX, 77807, USA. thirase@houstonmethodist.org.
FAU - Ling, Jeremiah F
AU  - Ling JF
AD  - Texas A&M University Health Science Center College of Medicine, 8447 Riverside 
      Pkwy, Bryan, TX, 77807, USA.
FAU - Haghshenas, Varan
AU  - Haghshenas V
AD  - Department of Orthopedics and Sports Medicine, Houston Methodist Hospital, 6445 
      Main St Suite 2500, Houston, TX, 77030, USA.
FAU - Fuld, Richard 3rd
AU  - Fuld R 3rd
AD  - Department of Orthopedics and Sports Medicine, Houston Methodist Hospital, 6445 
      Main St Suite 2500, Houston, TX, 77030, USA.
FAU - Dong, David
AU  - Dong D
AD  - Department of Orthopedics and Sports Medicine, Houston Methodist Hospital, 6445 
      Main St Suite 2500, Houston, TX, 77030, USA.
FAU - Hanson, Darrell S
AU  - Hanson DS
AD  - Department of Orthopedics and Sports Medicine, Houston Methodist Hospital, 6445 
      Main St Suite 2500, Houston, TX, 77030, USA.
FAU - Meyer, B Christoph
AU  - Meyer BC
AD  - Department of Orthopedics and Sports Medicine, Houston Methodist Hospital, 6445 
      Main St Suite 2500, Houston, TX, 77030, USA.
FAU - Marco, Rex A W
AU  - Marco RAW
AD  - Department of Orthopedics and Sports Medicine, Houston Methodist Hospital, 6445 
      Main St Suite 2500, Houston, TX, 77030, USA.
LA  - eng
PT  - Journal Article
DEP - 20220604
PL  - England
TA  - BMC Musculoskelet Disord
JT  - BMC musculoskeletal disorders
JID - 100968565
SB  - IM
MH  - Female
MH  - Humans
MH  - Male
MH  - Obesity/complications/diagnosis/epidemiology
MH  - *Postoperative Complications/epidemiology/etiology/surgery
MH  - Reoperation
MH  - Retrospective Studies
MH  - *Spine/surgery
PMC - PMC9166525
OTO - NOTNLM
OT  - Complex
OT  - Low muscle mass
OT  - Obesity
OT  - Predictor
OT  - Revision thoracolumbar spine surgery
COIS- Takashi Hirase, Jeremiah Ling, Varan Haghshenas, Richard Fuld III, David Dong, 
      and B Christoph Meyer declare no potential conflicts of interest with respect to 
      research, authorship, and/or publication of this article. Rex AW Marco has the 
      following disclosures: DePuy, A Johnson & Johnson Company: Paid presenter or 
      speaker; Globus Medical: Paid presenter or speaker; Musculoskeletal Tumor 
      Society: Board or committee member; Stryker: Paid presenter or speaker; Synaptive 
      Medical: Paid presenter or speaker. Darrell S Hanson has the following 
      disclosures: DePuy, A Johnson & Johnson Company: IP royalties; Paid consultant; 
      Paid presenter or speaker; Medtronic Sofamor Danek: Paid consultant; Paid 
      presenter or speaker.
EDAT- 2022/06/07 06:00
MHDA- 2022/06/09 06:00
PMCR- 2022/06/04
CRDT- 2022/06/06 11:02
PHST- 2021/08/07 00:00 [received]
PHST- 2022/06/01 00:00 [accepted]
PHST- 2022/06/06 11:02 [entrez]
PHST- 2022/06/07 06:00 [pubmed]
PHST- 2022/06/09 06:00 [medline]
PHST- 2022/06/04 00:00 [pmc-release]
AID - 10.1186/s12891-022-05505-4 [pii]
AID - 5505 [pii]
AID - 10.1186/s12891-022-05505-4 [doi]
PST - epublish
SO  - BMC Musculoskelet Disord. 2022 Jun 4;23(1):534. doi: 10.1186/s12891-022-05505-4.