Department of Neurosurgery, The Royal Melbourne Hospital, Grattan Street, Parkville, VIC 3050, Australia.
J Clin Neurosci. 2013 Dec;20(12):1713-7. doi: 10.1016/j.jocn.2013.01.021. Epub 2013 Aug 30.
Smoking and diabetes have long been considered risk factors for poor surgical outcome. However, the precise role of smoking and diabetes in the development of poor outcome in lumbar spinal surgery remains ambiguous. This study was undertaken to determine the effects of diabetes and smoking specifically on lumbar spinal surgery outcomes. A retrospective cohort study studied 902 patients who underwent lumbar spinal surgery at the Royal Melbourne Hospital, Australia, between 2001 and 2005, inclusively. Four groups were formed: control; diabetic; positive smoking history; and diabetic and positive smoking history. Multivariate analysis was used to analyse the likelihood of developing complications with a history of diabetes and/or smoking. Our findings indicate that diabetes was significantly associated with an increased risk of developing complications. Patients in the diabetic groups were also significantly older and had a longer length of stay than the other patients (p<0.05 for all significant findings). We conclude that diabetes does increase the risk of poor outcome following lumbar spinal surgery. However, we found no association between a positive smoking history and an increased rate of poor outcome.
吸烟和糖尿病一直被认为是手术效果不佳的风险因素。然而，吸烟和糖尿病在腰椎手术不良结局发展中的确切作用仍不清楚。本研究旨在确定糖尿病和吸烟对腰椎手术结果的具体影响。一项回顾性队列研究纳入了 2001 年至 2005 年期间在澳大利亚皇家墨尔本医院接受腰椎手术的 902 名患者。共分为四组：对照组、糖尿病组、有吸烟史组和糖尿病合并有吸烟史组。采用多变量分析来分析有糖尿病和/或吸烟史的患者发生并发症的可能性。我们的研究结果表明，糖尿病与发生并发症的风险增加显著相关。糖尿病组的患者也显著比其他患者年龄更大，住院时间更长（所有显著发现的 p 值均<0.05）。我们得出结论，糖尿病确实会增加腰椎手术后不良结局的风险。然而，我们没有发现吸烟史与不良结局发生率增加之间存在关联。
