TY - JOUR
T1 - Reduced Impact of Smoking Status on 30-Day Complication and Readmission Rates After Elective Spinal Fusion (≥3 Levels) for Adult Spine Deformity
T2 - A Single Institutional Study of 839 Patients
AU - Elsamadicy, Aladine A.
AU - Adogwa, Owoicho
AU - Sergesketter, Amanda
AU - Vuong, Victoria D.
AU - Lydon, Emily
AU - Behrens, Shay
AU - Cheng, Joseph
AU - Bagley, Carlos A.
AU - Karikari, Isaac O.
N1 - Publisher Copyright:
© 2017 Elsevier Inc.
PY - 2017/11
Y1 - 2017/11
N2 - Background Smoking status has been shown to affect postoperative outcomes after surgery. The aim of this study was to determine whether patients’ smoking status impacts 30-day complication and readmission rates after elective complex spinal fusion (≥3 levels). Methods The medical records of 839 adult spinal deformity patients undergoing elective complex spinal fusion (≥3 levels) at a major academic institution from 2005 to 2015 were reviewed. We identified 124 (14.8%) smokers and 715 (85.2%) nonsmokers. Patient demographics, comorbidities, intraoperative and postoperative complications, and 30-day readmission rates were collected for each patient. The primary outcome investigated in this study was the rate of 30-day postoperative complication and readmission rates. Results Patient demographics and comorbidities were similar between both groups, including age, sex, and body mass index. Median [interquartile] number of fusion levels and operative time were similar between the cohorts (smoker: 5 [4–7] vs. nonsmoker: 5 [4–8], P = 0.58) and (smoker: 309.6 ± 157.9 minutes vs. nonsmoker: 287.5 ± 131.7 minutes, P = 0.16), respectively. Both cohorts had similar postoperative complication rates and lengths of hospital stay. There was no significant difference in 30-day readmission between the cohorts (smoker: 12.9% vs. nonsmoker: 10.8%, P = 0.48). There were no observed differences in 30-day complication rates, including pain (P = 0.46), UTI (P = 0.54), hardware failure (P = 0.36), wound dehiscence (P = 0.29), and wound drainage (P = 0.86). Smokers had greater rates of 30-day cellulitis (smoker: 1.6% vs. nonsmoker: 0.3%, P = 0.05) and DVT (smoker: 0.8% vs. nonsmoker: 0.0%, P = 0.02). Conclusions Our study suggests that smoking does not significantly affect 30-day readmission rates after complex spinal surgery requiring ≥3 levels of fusion. Further studies are necessary to corroborate our findings.
AB - Background Smoking status has been shown to affect postoperative outcomes after surgery. The aim of this study was to determine whether patients’ smoking status impacts 30-day complication and readmission rates after elective complex spinal fusion (≥3 levels). Methods The medical records of 839 adult spinal deformity patients undergoing elective complex spinal fusion (≥3 levels) at a major academic institution from 2005 to 2015 were reviewed. We identified 124 (14.8%) smokers and 715 (85.2%) nonsmokers. Patient demographics, comorbidities, intraoperative and postoperative complications, and 30-day readmission rates were collected for each patient. The primary outcome investigated in this study was the rate of 30-day postoperative complication and readmission rates. Results Patient demographics and comorbidities were similar between both groups, including age, sex, and body mass index. Median [interquartile] number of fusion levels and operative time were similar between the cohorts (smoker: 5 [4–7] vs. nonsmoker: 5 [4–8], P = 0.58) and (smoker: 309.6 ± 157.9 minutes vs. nonsmoker: 287.5 ± 131.7 minutes, P = 0.16), respectively. Both cohorts had similar postoperative complication rates and lengths of hospital stay. There was no significant difference in 30-day readmission between the cohorts (smoker: 12.9% vs. nonsmoker: 10.8%, P = 0.48). There were no observed differences in 30-day complication rates, including pain (P = 0.46), UTI (P = 0.54), hardware failure (P = 0.36), wound dehiscence (P = 0.29), and wound drainage (P = 0.86). Smokers had greater rates of 30-day cellulitis (smoker: 1.6% vs. nonsmoker: 0.3%, P = 0.05) and DVT (smoker: 0.8% vs. nonsmoker: 0.0%, P = 0.02). Conclusions Our study suggests that smoking does not significantly affect 30-day readmission rates after complex spinal surgery requiring ≥3 levels of fusion. Further studies are necessary to corroborate our findings.
KW - 30-Day readmission
KW - Complication
KW - Deformity
KW - Fusion
KW - Smoking
KW - Spine surgery
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U2 - 10.1016/j.wneu.2017.07.174
DO - 10.1016/j.wneu.2017.07.174
M3 - Article
C2 - 28790002
AN - SCOPUS:85028347597
SN - 1878-8750
VL - 107
SP - 233
EP - 238
JO - World neurosurgery
JF - World neurosurgery
ER -