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Preoperative Dehydration Predicts Adverse Events Following Anterior Cervical Discectomy and Fusion – Lumbar Fusion

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The article discusses the correlation between preoperative dehydration and postoperative outcomes in patients undergoing anterior cervical discectomy and fusion (ACDF) surgery for neck arthritis. The study analyzed data from the American College of Surgeons National Surgical Quality Improvement Program database and identified 14,932 patients who underwent ACDF surgery. Among them, 28.1% were preoperatively dehydrated. The results showed that dehydrated patients had significantly higher odds of wound, hematological, and pulmonary complications, as well as a lower likelihood of being discharged home. They also had a prolonged length of hospital stay. The study suggests that evaluating a patient’s hydration status before surgery can help in risk stratification, patient counseling, and timing of ACDF surgeries

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
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Published article

: Preoperative dehydration is common among ACDF surgery patients and appears to correlate with an increased risk of postoperative complications and prolonged length of hospital stay. Evaluation of a patient’s hydration status from standard preoperative laboratory metrics can be employed for risk stratification, patient counseling, and timing of ACDF surgeries.

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Int J Spine Surg. 2023 Sep 28:8544. doi: 10.14444/8544. Online ahead of print.ABSTRACTBACKGROUND: Anterior cervical discectomy and fusion (ACDF) is a common procedure for neck arthritis, typically alleviating pain and improving function. Preoperative dehydration has been correlated with postoperative infection, acute renal failure, deep vein thrombosis, and increased hospital length of stay. However, some studies,

Int J Spine Surg. 2023 Sep 28:8544. doi: 10.14444/8544. Online ahead of print.

ABSTRACT

BACKGROUND: Anterior cervical discectomy and fusion (ACDF) is a common procedure for neck arthritis, typically alleviating pain and improving function. Preoperative dehydration has been correlated with postoperative infection, acute renal failure, deep vein thrombosis, and increased hospital length of stay. However, some studies have suggested that preoperative dehydration has a minimal relationship with postoperative outcomes, specifically in arthroplasty and lumbar surgery candidates.

METHODS: Patients who underwent ACDF from 2015 to 2020 as part of the American College of Surgeons National Surgical Quality Improvement Program database were identified. We excluded patients who presented with acute trauma. Dehydration was determined using the accepted definition of preoperative blood urea nitrogen to creatinine ratio greater than 20. Lengths of stay and 30-day postoperative adverse events were compared between dehydrated and nondehydrated cohorts, adjusting for baseline features using standard multivariate regression.

RESULTS: We identified 14,932 patients, and 4206 (28.1%) of whom were preoperatively dehydrated. Dehydrated patients had significantly higher odds of wound, hematological, and pulmonary complications; Clavien-Dindo grade IV, delayed length of stay (>5 days); and a lower likelihood of being discharged home (P < 0.005), even after controlling for demographic features (eg, sex, age, body mass index, race, and ethnicity). Furthermore, linear regression suggested an overall half-day increased length of hospital stay for dehydrated patients (95% CI [0.36, 0.60], P < 0.001).

: Preoperative dehydration is common among ACDF surgery patients and appears to correlate with an increased risk of postoperative complications and prolonged length of hospital stay. Evaluation of a patient’s hydration status from standard preoperative laboratory metrics can be employed for risk stratification, patient counseling, and timing of ACDF surgeries.

PMID:37770192 | DOI:10.14444/8544

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Preoperative Dehydration Predicts Adverse Events Following Anterior Cervical Discectomy and Fusion

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Int J Spine Surg. 2023 Sep 28:8544. doi: 10.14444/8544. Online ahead of print.ABSTRACTBACKGROUND: Anterior cervical discectomy and fusion (ACDF) is a common procedure for neck arthritis, typically alleviating pain and improving function. Preoperative dehydration has been correlated with postoperative infection, acute renal failure, deep vein thrombosis, and increased hospital length of stay. However, some studies

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