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

Peter G Passias; Cole Bortz; Haddy Alas; Frank A Segreto; Samantha R Horn; Yael U Ihejirika; Dennis Vasquez-Montes; Katherine E Pierce; Avery E Brown; Kartik Shenoy; Edward M DelSole; Bradley Johnson; Cheongeun Oh; Peter L Zhou; Chloe Deflorimonte; Ekhamjeet S Dhillon; Pawel P Jankowski; Bassel G Diebo; Virginie Lafage; Renaud Lafage; Shaleen N Vira; John A Bendo; Jeffrey A Goldstein; Frank J Schwab; Michael C Gerling

doi:10.1016/j.jor.2018.12.011

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

J Orthop. 2018 Dec 20;16(1):36-40. doi: 10.1016/j.jor.2018.12.011. eCollection 2019 Jan-Feb.

Authors

Peter G Passias¹, Cole Bortz¹, Haddy Alas¹, Frank A Segreto¹, Samantha R Horn¹, Yael U Ihejirika¹, Dennis Vasquez-Montes¹, Katherine E Pierce¹, Avery E Brown¹, Kartik Shenoy¹, Edward M DelSole¹, Bradley Johnson¹, Cheongeun Oh¹, Peter L Zhou¹, Chloe Deflorimonte¹, Ekhamjeet S Dhillon², Pawel P Jankowski¹, Bassel G Diebo³, Virginie Lafage⁴, Renaud Lafage⁴, Shaleen N Vira¹, John A Bendo¹, Jeffrey A Goldstein¹, Frank J Schwab⁴, Michael C Gerling¹

Affiliations

¹ Department of Orthopedic Surgery, NYU Langone Orthopedic Hospital, New York, NY, USA.
² Department of Orthopedic Surgery, University of Washington, Seattle, WA, USA.
³ Department of Orthopedic Surgery, SUNY Downstate Medical Center, Brooklyn, NY, USA.
⁴ Department of Orthopedic Surgery, Hospital for Special Surgery, New York, NY, USA.

Abstract

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 t-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,p=0.026).

Conclusions: Alcoholism and surgical revision are major risk factors for pseudarthrosis in patients undergoing spine fusion.

Keywords: 30-Day complication rates; Alcoholism; Predictors; Primary spine fusion; Pseudarthrosis; Surgical revision.