P23. How important is losing weight for the spine patient? The utility of simple weight measurements in preoperative optimization for spinal surgery

Abstract

<h3>BACKGROUND CONTEXT</h3> Orthopedic and neurosurgeons who specialize in spine surgery spend a significant amount of time and energy in their patient selection. While it is apparent that patients who appear "healthy" tend to succeed, there is a surprising paucity of data in the spine literature to quantify the benefits of weight loss in spinal surgery. <h3>METHODS</h3> We performed a retrospective cohort study involving patients undergoing spine surgery from 2011-2015 who were registered with the National Surgery Quality Improvement Project Participant Use Data File, and reviewed the effect of mean weight of the surgical patient with 30-day postsurgical outcomes including: surgical site infection, wound dehiscence, postoperative pneumonia, reintubation, pulmonary embolism, failure to wean off the ventilator, renal insufficiency, renal failure, urinary tract infection, myocardial infarction, bleeding complications requiring transfusion, deep venous thrombosis, readmission rates and reoperation rates. <h3>RESULTS</h3> In a sample of 2,876 patients who underwent spinal procedures (determined by the use of CPT codes 22010-22899, and codes 62263-63746), preoperative weight was determined to significantly correlate with 30-day postoperative risk of superficial site infections but notably not with deep incisional infections, occurrences of pulmonary embolisms but notably not of deep venous thrombosis, bleeding complications requiring transfusion, and occurrences of sepsis. Superficial Surgical Site Infections: significantly associated (p = 0.015)No Superficial Infections: 184.6 (45.3)Superficial Surgical Infections: 209.3 (53.8)Deep Surgical Wound Infections: not significantly associated (p = 0.985)No Deep Surgical Wound Infections: 184.9 (54.8)Deep Surgical Wound Infections: 184.8 (45.3)Deep Venous Thrombosis: not significantly associated (p = 0.334)No DVT: 184.7 (45.4)DVT: 193.7 (49.5)Pulmonary Embolisms: significantly associated (p = 0.020)No PE: 184.7 (45.4)PE: 215.2 (44.1)Sepsis: significantly associated (p = 0.032)No Sepsis: 184.6 (45.3)Sepsis: 206.0 (57.1) <h3>CONCLUSIONS</h3> Choosing the appropriate surgical candidates is paramount as a spine surgeon. There is much evidence for how to identify patients at risk for devastating postoperative complications, but spine surgeons should keep in mind that simple parameters such as weight are an effective screening tool for poor surgical candidates. Particularly in cases of elective spine surgery, a simple weight measurement in the office can save time and money when identifying high-risk patients. <h3>FDA DEVICE/DRUG STATUS</h3> This abstract does not discuss or include any applicable devices or drugs.