酒精成瘾作为原发性脊柱融合术中假关节形成的预测因素：对2005年至2013年52402例患者的危险因素及30天预后分析
Alcoholism as a predictor for pseudarthrosis in primary spine fusion: An analysis of risk factors and 30-day outcomes for 52,402 patients from 2005 to 2013.
作者信息
Passias Peter G, Bortz Cole, Alas Haddy, Segreto Frank A, Horn Samantha R, Ihejirika Yael U, Vasquez-Montes Dennis, Pierce Katherine E, Brown Avery E, Shenoy Kartik, DelSole Edward M, Johnson Bradley, Oh Cheongeun, Zhou Peter L, Deflorimonte Chloe, Dhillon Ekhamjeet S, Jankowski Pawel P, Diebo Bassel G, Lafage Virginie, Lafage Renaud, Vira Shaleen N, Bendo John A, Goldstein Jeffrey A, Schwab Frank J, Gerling Michael C
机构信息
Department of Orthopedic Surgery, NYU Langone Orthopedic Hospital, New York, NY, USA.
Department of Orthopedic Surgery, University of Washington, Seattle, WA, USA.
出版信息
J Orthop. 2018 Dec 20;16(1):36-40. doi: 10.1016/j.jor.2018.12.011. eCollection 2019 Jan-Feb.
INTRODUCTION
This study assessed the incidence and risk factors for pseudarthrosis among primary spine fusion patients.
METHODS
Retrospective review of ACS-NSQIP (2005-2013). Differences in comorbidities between spine fusion patients with and without pseudarthrosis (Pseud, N-Pseud) were assessed using chi-squared tests and Independent Samples -tests. Binary logistic regression assessed patient-related and procedure-related predictors for pseudarthrosis.
RESULTS
52,402 patients (57yrs, 53%F, 0.4% w/pseudarthrosis). Alcohol consumption (OR:2.6[1.2-5.7]) and prior history of surgical revision (OR:1.6[1.4-1.8]) were risk factors for pseudarthrosis operation. Pseud patients at higher risk for deep incisional SSI (at 30-days:OR:6.6[2.0-21.8]). Pseud patients had more perioperative complications (avg:0.24 ± 0.43v0.18 ± 0.39,=0.026).
CONCLUSIONS
Alcoholism and surgical revision are major risk factors for pseudarthrosis in patients undergoing spine fusion.
引言
本研究评估了初次脊柱融合手术患者中假关节形成的发生率及危险因素。
方法
对美国外科医师协会国家外科质量改进计划（ACS-NSQIP，2005 - 2013年）的数据进行回顾性分析。采用卡方检验和独立样本t检验评估发生与未发生假关节形成（假关节组、非假关节组）的脊柱融合手术患者在合并症方面的差异。二元逻辑回归分析评估与假关节形成相关的患者因素和手术因素。
结果
共纳入52402例患者（平均年龄57岁，53%为女性，0.4%发生假关节形成）。饮酒（比值比[OR]：2.6[1.2 - 5.7]）和既往手术翻修史（OR：1.6[1.4 - 1.8]）是假关节形成手术的危险因素。假关节组患者发生深部切口手术部位感染的风险更高（术后30天：OR：6.6[2.0 - 21.8]）。假关节组患者围手术期并发症更多（平均：0.24±0.43对0.18±0.39，P = 0.026）。
结论
酗酒和手术翻修是脊柱融合手术患者发生假关节形成的主要危险因素。
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