잠시만 기다려 주세요. 로딩중입니다.

Incidence and Risk Factors of Gastrointestinal and Hepatobiliary Complications after Spinal Fusion Surgery: a Retrospective Cohort Study

Journal of Korean Medical Science 2020년 35권 40호 p.345 ~ 345
박지훈, 김영훈, 박형열, Min Hyung-Ki, 김상일, 하기용,
소속 상세정보
박지훈 ( Bahk Ji-Hoon ) - Catholic University College of Medicine Seoul St. Mary’s Hospital Department of Orthopaedic Surgery
김영훈 ( Kim Young-Hoon ) - Catholic University College of Medicine Seoul St. Mary’s Hospital Department of Orthopaedic Surgery
박형열 ( Park Hyung-Youl ) - Catholic University College of Medicine Eunpyeong St. Mary’s Hospital Department of Orthopedic Surgery
 ( Min Hyung-Ki ) - Catholic University College of Medicine Seoul St. Mary’s Hospital Department of Orthopedic Surgery
김상일 ( Kim Sang-Il ) - Catholic University College of Medicine Seoul St. Mary’s Hospital Department of Orthopedic Surgery
하기용 ( Ha Kee-Yong ) - Kyung Hee University School of Medicine Kyung Hee University Hospital at Gangdong Department of Orthopaedic Surgery

Abstract


Background: Spinal surgery holds a higher chance of unpredicted postoperative medical complications among orthopedic surgeries. Several studies have analyzed the risk factors for diverse postoperative medical complications, but the majority investigated incidences of each complication qualitatively. Among gastrointestinal complications, reports regarding postoperative ileus were relatively frequent. However, risk factors or incidences of hepatobiliary complications have yet to be investigated. The purpose of this study was to examine the incidence of gastrointestinal complications after spinal surgery, quantitatively analyze the risk factors of frequent complications, and to determine cues requiring early approaches.

Methods: In total, 234 consecutive patients who underwent spinal fusion surgery performed by one senior doctor at our institute in one-year period were retrospectively enrolled for analyses. The primary outcomes were presence of paralytic ileus, elevated serum alanine transaminase (ALT) and aspartate transaminase (AST) levels, and elevated total bilirubin levels. Univariate logistic regression analyses of all variables were performed. In turn, significant results were reanalyzed by multivariate logistic regression. The variables used were adjusted with age and gender.

Results: Gastrointestinal complications were observed in 15.8% of patients. Upon the risk factors of postoperative ileus, duration of anesthesia (odds ratio [OR], 1.373; P = 0.015), number of fused segments (OR, 1.202; P = 0.047), and hepatobiliary diseases (OR, 2.976; P = 0.029) were significantly different. For elevated liver enzymes, men (OR, 2.717; P = 0.003), number of fused segments (OR, 1.234; P = 0.033), and underlying hepatobiliary (OR, 2.704; P = 0.031) and rheumatoid diseases (OR, 5.021; P = 0.012) had significantly different results. Lastly, risk factors for total bilirubin elevation were: duration of anesthesia (OR, 1.431; P = 0.008), number of fused segments (OR, 1.359; P = 0.001), underlying hepatobiliary diseases (OR, 3.426; P = 0.014), and thoracolumbar junction involving fusions (OR, 4.134; P = 0.002) compared to lumbar spine limited fusions.

Conclusion: Patients on postoperative care after spinal surgery should receive direct attention as soon as possible after manifesting abdominal symptoms. Laboratory and radiologic results must be carefully reviewed, and early consultation to gastroenterologists or general surgeons is recommended to avoid preventable complications.

키워드

Spinal Fusion; Postoperative Complications; Digestive System Diseases; Incidence; Risk Factors

원문 및 링크아웃 정보

 

등재저널 정보