Association of Pre- and Postoperative Values of Creatinkinase, Hemoglobin, and C-Reactive Protein with the Outcome of Patients with Lumbar Fusion Surgery

Abstract

Aim: The aim of this study was to determine whether complications in lumbar fusion surgery can be estimated from pre- or postoperative levels of different laboratory values. In addition, based on the results, we aim to predict in which patients a postoperative laboratory analysis might be of profit and alter the postoperative management. Methods: We retrospectively collected data of patients undergoing lumbar fusion surgery in our departments between January 2014 and February 2015. The patients were divided into four groups: group A included patients with no complications, group B patients with at least one surgical complication, group C patients with at least one medical complication, and group D patients with both a surgical and a medical complication. Levels of pre- and postoperative creatinkinase (CK), hemoglobin (Hb), and C-reactive protein (CRP) were compared between the groups and analyzed for possible impact on outcome and complications. Results: Data of 105 consecutive patients (65 women [61.9%]) were analyzed operated at a median age of 73 years (range: 26–88 years). Group A included 59 patients (56.2%), group B 27 patients (25.7%), group C 28 patients (26.7%), and group D 9 patients (8.6%). Comparison of preoperative CRP levels revealed significant difference between the groups A and D (4.85 vs. 8.5 mg/L, p = 0.0441,), as well as postoperative CRP levels (105.82 vs. 178.46 mg/L, p = 0.0285), postoperative Hb levels (104.88 vs. 90.33 g/dL, p = 0.0198), and postoperative CK levels (321.31 vs. 688.22 IU/L, p = 0.0210). Grouping the results of groups B, C, and D together versus group A revealed significant different results for postoperative Hb levels (104.88 vs. 97.67 g/dL, p = 0.0336) and postoperative CK levels (321.31 vs. 497.58 IU/L, p = 0.0393). Conclusions: Patients with postoperative complications show significant higher pre- and postoperative CRP levels, higher CK levels, and lower postoperative Hb levels. Further analyses to underline the association of pre- and postoperative laboratory results with complication rate will be undertaken and presented. In addition, more patients will be included in the analyses to further specify our results.