Cardiac complications more likely with lumbar fusion vs. decompression

Cardiovascular Disease
Cardiovascular Disease

HealthDay News -- Cardiac complications are more frequent among patients undergoing lumbar fusion surgery versus lumbar decompression, researchers have found.

The number of cardiac events was 9.3 per 1,000 lumbar fusion cases vs. 4.0 per 1,000 decompression cases (P < 0.0005), Steven J. Fineberg, MD, from Rush University Medical Center in Chicago, and colleagues reported in Spine.

Complications were also more frequent with fusion versus decompression, resulting in more hospitalizations, greater costs and higher mortality, they added. The overall incidence of cardiac complications is 6.7 per 1,000 lumbar spine surgical procedures.

Fineberg and colleagues analyzed data from patients included in the Nationwide Inpatient Sample who underwent lumbar fusion or decompression for degenerative etiologies from 2002 to 2009. They assessed incidence, mortality, and associated risk factors for cardiac events for 578,457 lumbar spine procedures.

Compared with patients who did not experience complications, those with cardiac events were significantly older (9.4 years on average; P < 0.0005). When a cardiac event was present, hospitalizations, costs and mortality were significantly increased (P < 0.0005), the researchers found.

Independent predictors for cardiac events, included being 65 years or older, having acute blood loss anemia and having several comorbidities .

"On the basis of these findings, we think that patients with specified risk factors should be monitored closely and medically optimized in the perioperative period," the researchers wrote.


References

  1. Fineberg SJ et al. Surgery. 2013; 38(16):1422-1429.
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