June 04, 2019
Underlying liver disease increases the risk of a slate of postoperative complications following posterior lumbar fusion, according to a study published in World Neurosurgery.
“As the long-term survival of patients with liver disease continues to increase, a better understanding of the relationship between liver dysfunction and surgical outcomes is needed,” researchers wrote. “The identification of modifiable risk factors would allow them to be addressed and optimized preoperatively to decrease the incidence and severity of complications and improve patient outcomes after posterior lumbar fusion.”
The retrospective study included 2965 patients who had undergone elective posterior lumbar fusion between 2011 and 2014, nearly 56% of whom had underlying liver disease.
Patients with underlying liver disease tended to be older than 65, male, underweight or overweight, classified American Society of Anesthesiologists class 3 or higher, and had diabetes, pulmonary comorbidity, cardiac comorbidity, renal comorbidity, bleeding disorder, preoperative dyspnea at rest, and a prolonged operative time, researchers reported.
Patients with liver disease had a higher 30-day incidence of cardiac complications, pulmonary complications, renal complications, blood transfusion, sepsis, urinary tract infection, and prolonged hospitalization following surgery, univariate analysis showed.
Using adjusted multivariate regression analysis, researchers found liver disease to be independently associated with 30-day renal complications, pulmonary complications, sepsis, urinary tract infection, prolonged hospitalization, and blood transfusion.
Chakravorty A, White SJ, Ye IB, Cheung ZB, Kang-Wook Cho S. Effects of underlying liver disease on 30-day outcomes after posterior lumbar fusion. World Neurosurgery. 2019 February 6;[Epub ahead of print].