Naessig Sara, Para Ashok, Moattari Kevin, Imbo Bailey, Williamson Tyler K, Joujon-Roche Rachel, Tretiakov Peter, Passfall Lara, Krol Oscar, Kummer Nicholas, Ahmad Waleed, Pierce Katherine, Ayres Ethan, Vira Shaleen, Diebo Bassel, Passias Peter G
Department of Orthopedics, NYU Langone Orthopedic Hospital, New York, NY, USA.
Department of Orthopaedic Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
Int J Spine Surg. 2022 Jun;16(3):412-416. doi: 10.14444/8255.
Metabolic syndrome (MetS) is an amalgamation of medical disorders that ultimately increase patient complications. Factors such as obesity, hypertension, dyslipidemia, and diabetes are associated with this disease complex.
To assess the incremental value of improving MetS in relation to clinical outcomes.
Retrospective cohort study.
Patients undergoing elective spine surgery were isolated and separated into 2 groups: MetS patients (>2 metabolic variables: hypertension, diabetes, obesity, and triglycerides) and nonmetabolic patients (<2 metabolic variables). tests and tests compared differences in patient demographics. Resolution of metabolic factors was incrementally analyzed for their effect on perioperative complications through utilization of logistic regressions.
A total of 2,855,517 elective spine patients were included. Of them, 20.1% had MeTS (81.4% two factors, 18.4% three factors, 0.2% four factors). MetS patients were older, less female, and more comorbid ( < 0.001). About 28.8% MetS patients developed more complications such as anemia (9.8% vs 5.9%), device related (3.5% vs 2.9%), neurologic (2.3% vs 1.4%), and bowel issues (9.7% vs 6.8 %; < 0.05). Controlling for age and procedure invasiveness, having 3 MetS factors increased a patient's likelihood (0.89×) of developing a perioperative complication ( < 0.05), whereas 2 factors had lower odds (0.82). More specifically, patients who were diabetes, obese, and had hypertension had the greatest odds at developing a complication (0.58 [0.58-0.57]) followed by those who had concomitant hypertension, high triglycerides, and were obese (0.55 [0.63-0.48]; all < 0.001). MetS patients with 2 factors, being obese and having hypertension produced the lowest odds at developing a complication (0.5 [0.61-0.43]; < 0.001). These MetS patients also had a lower length of stay than those with 3 and 4 ( < 0.001).
Metabolic patients improved in perioperative complications incrementally, demonstrating the utility of efforts to mitigate burden of MetS even if not completely abolished.
This review contributes to the assessment of MetS optimization in the field of adult spine surgery.
代谢综合征（MetS）是多种医学病症的组合，最终会增加患者的并发症。肥胖、高血压、血脂异常和糖尿病等因素与这种疾病复合体相关。
评估改善代谢综合征对临床结局的增量价值。
回顾性队列研究。
将接受择期脊柱手术的患者分离并分为两组：代谢综合征患者（>2个代谢变量：高血压、糖尿病、肥胖和甘油三酯）和非代谢患者（<2个代谢变量）。通过检验和检验比较患者人口统计学差异。通过逻辑回归逐步分析代谢因素的解决对围手术期并发症的影响。
共纳入2,855,517例择期脊柱手术患者。其中，20.1%患有代谢综合征（81.4%为两个因素，18.4%为三个因素，0.2%为四个因素）。代谢综合征患者年龄较大，女性较少，合并症较多（<0.001）。约28.8%的代谢综合征患者出现更多并发症，如贫血（9.8%对5.9%）、器械相关（3.5%对2.9%）、神经（2.3%对1.4%）和肠道问题（9.7%对6.8%；<0.05）。在控制年龄和手术侵袭性后，有3个代谢综合征因素会增加患者发生围手术期并发症的可能性（0.89倍）（<0.05），而2个因素的可能性较低（0.82）。更具体地说，患有糖尿病、肥胖和高血压的患者发生并发症的可能性最大（0.58[0.58 - 0.57]），其次是伴有高血压、高甘油三酯和肥胖的患者（0.55[0.63 - 0.48]；均<0.001）。有2个因素（肥胖和高血压）的代谢综合征患者发生并发症的可能性最低（0.5[0.61 - 0.43]；<0.001）。这些代谢综合征患者的住院时间也比有3个和4个因素的患者短（<0.001）。
代谢综合征患者围手术期并发症逐步改善，表明即使不能完全消除，减轻代谢综合征负担的努力也是有用的。
本综述有助于评估成人脊柱手术领域中代谢综合征的优化情况。
