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Risk Factors, Additional Length of Stay, and Cost Associated with Postoperative Ileus Following Anterior Lumbar Interbody Fusion in the Elderly.
World Neurosurg. 2018 Apr 10;:
Authors: Horowitz JA, Jain A, Puvanesarajah V, Qureshi R, Hassanzadeh H
Abstract
OBJECTIVE: Identify the independent risk factors, additional length of stay, and additional cost associated with postoperative ileus following anterior lumbar interbody fusion in the elderly.
METHODS: The PearlDiver Patient Records Database (Young & Ellison, LLC, Colorado Springs, CO) was queried for all Medicare patients 65 years of age and older undergoing 1 or 2 level primary elective anterior lumbar interbody fusion from 2005-2014. Independent risk factors, additional length of stay, and additional cost associated with postoperative ileus were evaluated with multivariate analysis.
RESULTS: 13,139 patients were identified, and 642 patients experienced postoperative ileus within 3 days following surgery. Multivariate analysis identified perioperative fluid or electrolyte imbalance (odds ratio = 4.03, 95% confidence interval = 3.37 - 4.80, P < 0.001) and male sex (odds ratio = 1.72, 95% confidence interval = 1.48 - 2.00, P < 0.001) as independent risk factors for ileus. Multivariate analysis associated postoperative ileus with additional length of stay of 2.83 days ± 0.11 days (P < 0.001) and additional cost of $2,349 ± $419 (P < 0.001).
CONCLUSION: Patients with perioperative fluid and electrolyte imbalances were four times as likely to experience postoperative ileus. Fluid balance and electrolyte levels should be carefully monitored during the perioperative period in patients undergoing anterior lumbar interbody fusion as a potential means to reduce the incidence of postoperative ileus and the additional length of stay and cost burden associated with this complication.
PMID: 29653271 [PubMed - as supplied by publisher]
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