299. Does increasing body mass index correlate with adverse outcomes following posterior cervical fusions? An analysis of the NSQIP database

Abstract

BACKGROUND CONTEXT Obesity has been shown to be associated with higher rates of complications following lumbar spine surgery. However, the evidence regarding the impact of increasing body mass index (BMI) on postoperative outcomes following posterior cervical fusions remains limited. PURPOSE To evaluate the impact of increasing severity of body mass index on 30-day outcomes following posterior cervical fusions. STUDY DESIGN/SETTING Retrospective review of prospectively collected surgical registry. PATIENT SAMPLE The 2012-2017 American College of Surgeons – National Surgical Quality Improvement Program (ACS-NSQIP) database was queried using Current Procedural Terminology code 22600 to identify individuals undergoing posterior cervical fusions (PCFs). Patients undergoing concurrent anterior cervical spine surgery, surgery for deformity, malignancy and/or infection were excluded. Patients with missing data with regards to weight, height and 30-day outcomes were excluded from the study cohort. BMI (in kg/m2) was categorized into four groups – 1) OUTCOME MEASURES Thirty-day outcomes were subdivided into the following categories: 1) minor adverse events/MAE (superficial SSI, urinary tract infections, pneumonia and progressive renal insufficiency), 2) severe adverse events/SAE (deep SSI, organ/space SSI, wound dehiscence, unplanned intubation, pulmonary embolism, ventilator use >48 hours, acute renal failure, stroke, cardiac arrest, myocardial infarction, deep venous thrombosis, sepsis, septic shock, reoperation and mortality), 3) bleeding requiring transfusion, 4) readmissions and 5) any adverse event/AAE (SAE or MAE). METHODS Multivariate regression analyses were built to assess the independent impact of BMI on 30-day outcomes while controlling for baseline clinical characteristics. RESULTS Out of a total of 2,786 PCFs – 710 (25.5%) had a BMI CONCLUSIONS With the exception of a higher rate of deep SSIs seen in obese individuals, increasing severity of BMI does not seem to have a major impact on 30-day outcomes following PCFs. FDA DEVICE/DRUG STATUS This abstract does not discuss or include any applicable devices or drugs.