Unintended Consequences After Postoperative Ileus in Spinal Fusion Patients

Kevin Swong, Stephen Johans, Ayrin Molefe, Ryan C. Hofler, Michael Wemhoff, Paul Kuo, Anand Germanwala*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Background: Postoperative ileus is not uncommon after spinal surgery. Although previous research has focused on the frequency of ileus formation, little has been done to investigate the clinical sequelae after development. We investigated the effect of postoperative ileus on patients’ length of stay and rates of deep vein thrombosis (DVT) formation, myocardial infarction (MI), aspiration pneumonia, sepsis, and death. Methods: The Healthcare Cost and Utilization Project National Inpatient Sample was queried to identify adult patients who underwent any spinal fusion procedure. Patient characteristics and outcomes for discharges involving spinal fusion surgery were compared between patients with and without postoperative ileus. The Rao-Scott χ 2 test of association was used for categorical variables, and a t test for equality of means was used for continuous variables. Among discharges with postoperative ileus, a multivariate linear regression model was used to assess how fusion approach and fusion length were associated with length of hospital stay, controlling for sex, age, and race. Results: A total of 250,221 patients were included. The mean length of stay was 3.75 days for patients without postoperative ileus and 9.40 days for patients with postoperative ileus. Patients with postoperative ileus are more likely to have DVT (4.1% vs. 20.8%, P < 0.001), MI (2.5% vs. 7.1%, P < 0.001), aspiration pneumonia (6.6% vs. 34.3%, P < 0.001), sepsis (5.7% vs. 35.7%, P < 0.001), and death (2.6% vs. 11.4%, P < 0.001). Conclusions: This study demonstrates that patients with postoperative ileus are significantly more likely to have DVT, experience MI, acquire aspiration pneumonia, develop sepsis, and die.

Original languageEnglish (US)
Pages (from-to)e512-e515
JournalWorld neurosurgery
Volume122
DOIs
StatePublished - Feb 2019
Externally publishedYes

Keywords

  • Database
  • Ileus
  • Length of stay
  • Spinal fusion

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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