Katsevman Gennadiy A, Daffner Scott D, Brandmeir Nicholas J, Emery Sanford E, France John C, Sedney Cara L
Department of Neurosurgery, 5631West Virginia University, Morgantown, WV, USA.
Department of Orthopaedics, 5631West Virginia University, Morgantown, WV, USA.
Global Spine J. 2022 Apr;12(3):409-414. doi: 10.1177/2192568220953393. Epub 2020 Sep 1.
Retrospective chart review with matched control.
To evaluate the indications and complications of spine surgery on super obese patients.
A retrospective review assessed super obese patients undergoing spine surgery at a level-1 trauma and spine referral center from 2012 to 2016. Outcomes were compared to age-matched controls with body mass index (BMI) <50 kg/m. The control group was further subdivided into patients with BMI <30 kg/m (normal) and BMI between 30 and 50 kg/m (obese).
Sixty-three super obese patients undergoing 86 surgeries were identified. Sixty patients (78 surgeries) were in the control group. Age and number of elective versus nonelective cases were not significantly different. Mean BMI of the super obese group was 55 kg/m (range 50-77 kg/m) versus 29 kg/m in the controls (range 20-49 kg/m). Fifty-two percent of surgeries were elective, and the most common indication was degenerative disease (39%). Compared with controls, super obese patients had a higher complication rate (30% [n = 19] vs 10% [N = 6], = .0055) but similar 30-day mortality rate (5% vs 5%), a finding that was upheld when comparing super obese with each of the control group stratifications (BMI 30-50 and BMI <30 kg/m). The most common complication among super obese patients was wound dehiscence/infection (n = 8, 13%); 2 patients' surgeries were aborted. Complication rates for elective surgery were 21% (n = 7) for super obese patients and 4% (n = 1) for controls ( = .121); complication rates for nonelective procedures were 40% (n = 12) and 14% (n = 5), respectively ( = .023).
The complication rate of spine surgery in super obese patients (BMI ≥ 50 kg/m) is significantly higher than other patients, particularly for nonelective cases.
采用配对对照的回顾性病历审查。
评估超级肥胖患者脊柱手术的适应证及并发症。
对2012年至2016年在一家一级创伤和脊柱转诊中心接受脊柱手术的超级肥胖患者进行回顾性评估。将结果与体重指数（BMI）<50kg/m²的年龄匹配对照组进行比较。对照组进一步细分为BMI<30kg/m²（正常）和BMI在30至50kg/m²（肥胖）的患者。
共确定63例接受86次手术的超级肥胖患者。对照组有60例患者（78次手术）。年龄以及择期与非择期病例数无显著差异。超级肥胖组的平均BMI为55kg/m²（范围50 - 77kg/m²），而对照组为29kg/m²（范围20 - 49kg/m²）。52%的手术为择期手术，最常见的适应证是退行性疾病（39%）。与对照组相比，超级肥胖患者的并发症发生率更高（30% [n = 19] 对10% [N = 6]，P = 0.0055），但30天死亡率相似（5%对5%），在将超级肥胖患者与对照组的每个分层（BMI 30 - 50和BMI<30kg/m²）进行比较时这一结果均成立。超级肥胖患者中最常见的并发症是伤口裂开/感染（n = 8，13%）；2例患者的手术中止。超级肥胖患者择期手术的并发症发生率为21%（n = 7），对照组为4%（n = 1）（P = 0.121）；非择期手术的并发症发生率分别为40%（n = 12）和14%（n = 5）（P = 0.023）。
超级肥胖患者（BMI≥50kg/m²）脊柱手术的并发症发生率显著高于其他患者，尤其是非择期手术。
