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Journal of Neurosurgical Sciences 2017 February;61(1):1-7

DOI: 10.23736/S0390-5616.16.03223-9


lingua: Inglese

The effect of diabetes mellitus on 30-day outcomes following single-level open lumbar microdiscectomy: an aged-matched case-control study

Patrick R. MALONEY 1, Sasha R. HALASZ 1, 2, Grant W. MALLORY 1, Lukas GRASSNER 1, Jeffrey T. JACOB 1, Ahmad NASSR 3, Michelle J. CLARKE 1

1 Department of Neurosurgery, Mayo Clinic, Rochester, MN, USA; 2 Mayo Medical School Mayo Clinic, Rochester, MN, USA; 3 Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA


BACKGROUND: Diabetes mellitus (DM) is a known risk factor for post-surgical complications. However, few reports specifically study lumbar spine surgical outcomes in diabetics. The purpose of this study was to assess 30-day outcomes in patients with DM undergoing single-level open lumbar microdiscectomy (oLMD).
METHODS: A retrospective case control study on patients with DM undergoing between 2001 and 2012. Patients who underwent a minimally invasive approach, repeat discectomy, or multilevel surgery were excluded. One hundred and twenty-six patients were age-matched with 126 non-diabetic controls. Outcomes assessed included length of stay (LOS), postoperative urinary retention (UR), total morbidity, infection, postoperative radiculitis, 30-day re-admissions and emergency department visits, and pain status at discharge and at 30 days. Categorical variables were evaluated with Pearson’s χ2 tests. Student’s t-tests were used to evaluate continuous variables. Univariate logistic regression was used to evaluate strength of association of DM with outcome variables.
RESULTS: Mean LOS was significantly higher in diabetic patients (1.9 vs. 1.4 days, P<0.0001). DM was associated with increased morbidity (P=0.009, OR=3.3, CI: 1.3-9.5) and UR (P<0.0001, OR=8.2, CI: 3.4-24.8). No differences were found in 30-day readmission rates or emergency department visits, pain status at discharge and at 30 days, or postoperative radiculitis.
CONCLUSIONS: Overall, short-term outcomes are worse in patients with DM. Following single-level oLMD, DM is associated with longer hospital stays, UR, and increased morbidity. These short term outcomes consequently lead to an overall increase in hospital costs.

KEY WORDS: Diabetes mellitus - Diskectomy - Length of stay - Urinary retention - Orthopedic procedures - Lumbosacral region

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