Risk Factors for Unplanned Reoperation Within 30 Days Following Elective Posterior Lumbar Spinal Fusion

Abstract

Study Design: Retrospective cohort study. Objectives: Unplanned reoperation following lumbar spinal fusion is detrimental to patients, providers, and health systems. The aim of this study was to identify risk factors associated with unplanned reoperation following elective posterior lumbar spinal fusion and assess the reasons for reoperation. Methods: A retrospective analysis of 22 151 patients from the American College of Surgeons National Surgical Quality Improvement Program data set between 2012 and 2015 was completed. The primary outcome measure was unplanned reoperation within 30 days. Secondary outcome measures were specific diagnoses and procedures associated with unplanned reoperation, as well as time to reoperation from initial procedure. Multiple stepwise logistic regression was employed to determine preoperative variables predictive of unplanned 30-day reoperation. Results: Patients with disseminated cancer (OR = 3.44, P =.0049), weight loss >10% in 6 months prior to surgery (OR = 3.26, P =.0276), bleeding disorders (OR = 1.92, P =.0049), American Society of Anesthesiologists score of 3 (OR = 1.46, P