The Impact of Chronic Kidney Disease on Postoperative Outcomes in Patients Undergoing Lumbar Decompression and Fusion

Owoicho Adogwa, Aladine A. Elsamadicy, Amanda Sergesketter, Deborah Oyeyemi, Diego Galan, Victoria D. Vuong, Syed Khalid, Joseph Cheng, Carlos A. Bagley, Isaac O. Karikari

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Objective: To determine whether preoperative chronic kidney disease (CKD) is associated with inferior perioperative outcomes in patients undergoing lumbar arthrodesis. Methods: Medical records of 293 adult (≥18 years old) patients with spine deformity undergoing elective lumbar spine decompression and fusion at a major academic institution from 2006 to 2015 were reviewed. We identified 18 (6.1%) patients with a clinical diagnosis of CKD (CKD group, n = 18; no-CKD group, n = 275). Patient demographics, comorbidities, and intraoperative and postoperative complication rates were collected for each patient. The primary endpoint was incidence of postoperative complications. Results: Patient demographics, including age, sex, and body mass index, and comorbidities were similar between cohorts. The CKD group had a significantly higher prevalence of hypertension, hyperlipidemia, and anemia compared with the no-CKD group. Median number of fusion levels, length of surgery, and estimated blood loss were similar between both cohorts. Postoperative complication profile was significantly different between the cohorts, with the CKD group having a significantly higher proportion of patients transferred to the intensive care unit (52.9% vs. 29.3%, P = 0.04) with episodes of delirium (27.8% vs. 8.4%, P = 0.007), urinary tract infection (27.8% vs. 6.9%, P = 0.0002), and deep vein thrombosis (5.6% vs. 0.4%, P = 0.01). Although not significant, the CKD group had a 2-fold higher rate of 30-day readmissions compared with the no-CKD group (CKD group: 27.8% vs. no-CKD group: 12.7%, P = 0.07). Conclusions: Our study suggests that patients with CKD may be more likely to develop perioperative complications after lumbar arthrodesis. Future studies are necessary to corroborate our findings.

Original languageEnglish (US)
JournalWorld Neurosurgery
DOIs
StateAccepted/In press - Jan 1 2017

Fingerprint

Decompression
Chronic Renal Insufficiency
Arthrodesis
Comorbidity
Spine
Demography
Delirium
Intraoperative Complications
Hyperlipidemias
Urinary Tract Infections
Venous Thrombosis
Medical Records
Intensive Care Units
Anemia
Body Mass Index
Hypertension

Keywords

  • Arthrodesis
  • Chronic kidney disease
  • CKD
  • Complications
  • Decompression
  • Outcomes
  • Readmission
  • Spine surgery

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

Cite this

Adogwa, O., Elsamadicy, A. A., Sergesketter, A., Oyeyemi, D., Galan, D., Vuong, V. D., ... Karikari, I. O. (Accepted/In press). The Impact of Chronic Kidney Disease on Postoperative Outcomes in Patients Undergoing Lumbar Decompression and Fusion. World Neurosurgery. https://doi.org/10.1016/j.wneu.2017.10.147

The Impact of Chronic Kidney Disease on Postoperative Outcomes in Patients Undergoing Lumbar Decompression and Fusion. / Adogwa, Owoicho; Elsamadicy, Aladine A.; Sergesketter, Amanda; Oyeyemi, Deborah; Galan, Diego; Vuong, Victoria D.; Khalid, Syed; Cheng, Joseph; Bagley, Carlos A.; Karikari, Isaac O.

In: World Neurosurgery, 01.01.2017.

Research output: Contribution to journalArticle

Adogwa, Owoicho ; Elsamadicy, Aladine A. ; Sergesketter, Amanda ; Oyeyemi, Deborah ; Galan, Diego ; Vuong, Victoria D. ; Khalid, Syed ; Cheng, Joseph ; Bagley, Carlos A. ; Karikari, Isaac O. / The Impact of Chronic Kidney Disease on Postoperative Outcomes in Patients Undergoing Lumbar Decompression and Fusion. In: World Neurosurgery. 2017.
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abstract = "Objective: To determine whether preoperative chronic kidney disease (CKD) is associated with inferior perioperative outcomes in patients undergoing lumbar arthrodesis. Methods: Medical records of 293 adult (≥18 years old) patients with spine deformity undergoing elective lumbar spine decompression and fusion at a major academic institution from 2006 to 2015 were reviewed. We identified 18 (6.1{\%}) patients with a clinical diagnosis of CKD (CKD group, n = 18; no-CKD group, n = 275). Patient demographics, comorbidities, and intraoperative and postoperative complication rates were collected for each patient. The primary endpoint was incidence of postoperative complications. Results: Patient demographics, including age, sex, and body mass index, and comorbidities were similar between cohorts. The CKD group had a significantly higher prevalence of hypertension, hyperlipidemia, and anemia compared with the no-CKD group. Median number of fusion levels, length of surgery, and estimated blood loss were similar between both cohorts. Postoperative complication profile was significantly different between the cohorts, with the CKD group having a significantly higher proportion of patients transferred to the intensive care unit (52.9{\%} vs. 29.3{\%}, P = 0.04) with episodes of delirium (27.8{\%} vs. 8.4{\%}, P = 0.007), urinary tract infection (27.8{\%} vs. 6.9{\%}, P = 0.0002), and deep vein thrombosis (5.6{\%} vs. 0.4{\%}, P = 0.01). Although not significant, the CKD group had a 2-fold higher rate of 30-day readmissions compared with the no-CKD group (CKD group: 27.8{\%} vs. no-CKD group: 12.7{\%}, P = 0.07). Conclusions: Our study suggests that patients with CKD may be more likely to develop perioperative complications after lumbar arthrodesis. Future studies are necessary to corroborate our findings.",
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AU - Oyeyemi, Deborah

AU - Galan, Diego

AU - Vuong, Victoria D.

AU - Khalid, Syed

AU - Cheng, Joseph

AU - Bagley, Carlos A.

AU - Karikari, Isaac O.

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KW - Complications

KW - Decompression

KW - Outcomes

KW - Readmission

KW - Spine surgery

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