TY - JOUR
T1 - Effect of patient's sex on early perioperative outcomes following anterior cervical discectomy and fusion
AU - Alomari, Safwan
AU - Liu, Ann
AU - Westbroek, Erick
AU - Witham, Timothy
AU - Bydon, Ali
AU - Lo, Sheng fu Larry
N1 - Funding Information:
We would like to acknowledge support for the statistical analysis from the National Center for Research Resources and the National Center for Advancing Translational Sciences (NCATS) of the National Institutes of Health through Grant Number 1UL1TR001079.
Publisher Copyright:
© 2021
PY - 2021/11
Y1 - 2021/11
N2 - Objective: Differences in morbidity and mortality measures between males and females have been demonstrated for a variety of spinal surgeries, however, studies of anterior cervical discectomy and fusion (ACDF) are limited. To investigate the impact of sex on 30-day perioperative outcomes of ACDF. Methods: Retrospective 1:1 propensity score-matched cohort study. Patients who underwent ACDF between 2016 and 2018 were reviewed from the ACS-NSQIP database. Propensity score matching and subgroup analysis were used. Results: 21,180 patients met inclusion criteria. 11,194 patients underwent single-level ACDF and 9986 patients underwent multi-level ACDF. In the single-level group, there were 6168 (55.1%) males and 5026 (44.9%) females. In the multi-level group, there were 5033 (50.4%) males and 4953 (49.6%) females. In both single/multi-level groups, females were more likely to be of older age, be functionally dependent, and have higher BMI and lower preoperative hematocrit level. Males were more likely to be Caucasian, smokers, have myelopathy, diabetes mellitus, hypertension and bleeding disorders. In both single/multi-level groups, except for the higher incidence of urinary tract infection (UTI) in females and myocardial infarction (MI) in males, there were no significant differences in morbidity and mortality between males and females. Conclusions: Several differences in demographics and baseline health status exist between males and females undergoing ACDF. When attempting to control for comorbid conditions, we found that sex by itself is not an independent risk factor for higher perioperative morbidity or mortality in patients undergoing ACDF, except for the higher incidence of UTI in females and MI in males. These results are important findings for clinicians and spine surgeons while counseling patients undergoing this type of procedure.
AB - Objective: Differences in morbidity and mortality measures between males and females have been demonstrated for a variety of spinal surgeries, however, studies of anterior cervical discectomy and fusion (ACDF) are limited. To investigate the impact of sex on 30-day perioperative outcomes of ACDF. Methods: Retrospective 1:1 propensity score-matched cohort study. Patients who underwent ACDF between 2016 and 2018 were reviewed from the ACS-NSQIP database. Propensity score matching and subgroup analysis were used. Results: 21,180 patients met inclusion criteria. 11,194 patients underwent single-level ACDF and 9986 patients underwent multi-level ACDF. In the single-level group, there were 6168 (55.1%) males and 5026 (44.9%) females. In the multi-level group, there were 5033 (50.4%) males and 4953 (49.6%) females. In both single/multi-level groups, females were more likely to be of older age, be functionally dependent, and have higher BMI and lower preoperative hematocrit level. Males were more likely to be Caucasian, smokers, have myelopathy, diabetes mellitus, hypertension and bleeding disorders. In both single/multi-level groups, except for the higher incidence of urinary tract infection (UTI) in females and myocardial infarction (MI) in males, there were no significant differences in morbidity and mortality between males and females. Conclusions: Several differences in demographics and baseline health status exist between males and females undergoing ACDF. When attempting to control for comorbid conditions, we found that sex by itself is not an independent risk factor for higher perioperative morbidity or mortality in patients undergoing ACDF, except for the higher incidence of UTI in females and MI in males. These results are important findings for clinicians and spine surgeons while counseling patients undergoing this type of procedure.
KW - Anterior cervical discectomy and fusion (ACDF)
KW - Female
KW - Male
KW - Outcomes
KW - Propensity score matching
KW - Sex
KW - Subgroup analysis
UR - http://www.scopus.com/inward/record.url?scp=85115929394&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85115929394&partnerID=8YFLogxK
U2 - 10.1016/j.jocn.2021.09.015
DO - 10.1016/j.jocn.2021.09.015
M3 - Article
C2 - 34656256
AN - SCOPUS:85115929394
SN - 0967-5868
VL - 93
SP - 247
EP - 252
JO - Journal of Clinical Neuroscience
JF - Journal of Clinical Neuroscience
ER -