The Impact of Metabolic Syndrome on 30-Day Outcomes Following Elective Anterior Cervical Discectomy and Fusions.

STUDY DESIGN: Retrospective review of prospective registry OBJECTIVE.: To analyze the impact of metabolic syndrome (MetS) on 30-day outcomes following elective anterior cervical discectomy and fusions (ACDFs).

SUMMARY OF BACKGROUND DATA: MetS is defined as the presence of a combination of hypertension, diabetes mellitus, and obesity. Past literature has reported MetS to complicate postoperative care in patients undergoing various surgical procedures, including lumbar fusions.

METHODS: The 2015 to 2016 American College of Surgeons-National Surgical Quality Improvement Program (ACS-NSQIP) database was queried using current procedural terminology (CPT) codes 22,551 (single-level) and 22,552 (additional level). Patients undergoing disc arthroplasty, multi-level (>3) fusion, posterior cervical spine surgery, and patients with fracture, tumor, infection were excluded. MetS was defined using a pre-set criteria used by other NSQIP studies as the presence of-(1) diabetes mellitus, (2) hypertension requiring medication, and (3) body mass index (BMI) more than or equal to 30 kg/m.

RESULTS: A total of 1384 (8.8%) patients with MetS underwent a cervical fusion. Following adjusted analysis, results showed that presence of MetS was associated with higher odds of a prolonged length of stay more than or equal to 3 days (odds ratios [OR] 1.32 [95% confidence interval [CI] 1.12-1.56]; P = 0.001). No significant association was found between MetS and 30-day complications, 30-day reoperations, 30-day re-admissions, a non-home discharge, and death.

CONCLUSION: While MetS was associated with a prolonged length of stay, its presence does not have a large impact on 30-day outcomes following elective ACDF.

LEVEL OF EVIDENCE: 3.