%0 Journal Article
%T Chronic Obstructive Pulmonary Disease Is an Independent Predictor for 30
%A Azeem Tariq Malik
%A Elizabeth Yu
%A Jeffery Kim
%A Nikhil Jain
%A Safdar N. Khan
%J Global Spine Journal
%@ 2192-5690
%D 2019
%R 10.1177/2192568218794170
%X Retrospective cohort. To study evidence to assess the impact of chronic obstructive pulmonary disease (COPD) on 30-day outcomes following 1- to 2-level anterior cervical discectomy and fusion (ACDF). The 2015-2016 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, multilevel (>2) fusion, posterior cervical spine surgery, and patients with fracture, tumor, and/or infection were excluded. Out of 14£¿835 patients undergoing an elective 1- to 2-level ACDF, 649 (4.4%) had a diagnosis of COPD at the time of the surgery. Following adjusted logistic regression analysis, prior history of COPD was significantly associated with a longer length of stay (odds ratio [OR] 1.25 [95% confidence interval (CI0 1.04-1.52]; P = .019), superficial surgical site infection (OR 2.68 [95% CI 1.06-6.80]; P = .038), discharge destination other than home (OR 1.49 [95% CI 1.05-2.12]; P = .026), pneumonia (OR 4.37 [95% CI 2.42-7.88]; P < .001), ventilator use >48 hours (OR 5.34 [95% CI 1.88-15.15]; P = .002), unplanned reintubation (OR 3.36 [1.48-7.62]; P = .004), and 30-day readmissions (OR 1.69 [95% CI 1.20-2.38]; P = .003). The findings of this study show that COPD patients are more likely to have postoperative complications and 30-day readmissions, despite elective ACDF itself being a low-risk surgery in general. Results show that majority of the complications were pulmonary in nature, further stressing the need for accurate medical optimization following surgery in these patients
%K ACDF
%K anterior cervical discectomy and fusion
%K COPD
%K chronic obstructive pulmonary disease
%K cervical fusion
%K complications
%K readmissions
%K length of stay
%K non¨Chome discharge destination
%K pulmonary complications
%U https://journals.sagepub.com/doi/full/10.1177/2192568218794170