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Risk Factors for Postoperative Ileus in Patients Undergoing Spine Surgery
Nathan R Hendrickson1, Yue Zhang2, Linda Amoafo3
1Department of Orthopaedic Surgery, University of Utah, Salt Lake City, UT, USA.
Global Spine Journal
|February 7, 2022
Summary
Higher postoperative opioid doses increase the risk of postoperative ileus (POI) after thoracolumbar spine fusion. Managing pain effectively while minimizing opioid use is crucial for preventing this common complication.
Area of Science:
- Spine Surgery
- Gastroenterology
- Anesthesiology
Background:
- Postoperative ileus (POI) is a frequent complication following elective spinal surgeries.
- Identifying risk factors for POI is essential for improving patient outcomes.
Purpose of the Study:
- To determine the incidence of POI after elective instrumented thoracolumbar spine fusion.
- To identify demographic and surgical risk factors associated with POI.
Main Methods:
- Retrospective cohort study of 418 patients undergoing instrumented thoracolumbar fusion.
- Data abstracted from electronic medical records, including demographics, comorbidities, and opioid administration (MME).
- Univariate and multivariate logistic regression analyses were performed to identify risk factors.
Main Results:
- The incidence of POI was 9.3%.
- Fusion of 7 or more levels was associated with increased POI risk (P=.001).
- Total 24-hour postoperative MME was an independent risk factor for POI (OR 1.004, P=.04).
Conclusions:
- Increased postoperative opioid administration (MME) is an independent risk factor for POI after thoracolumbar spine fusion.
- Further prospective studies are needed to develop strategies for reducing POI risk.
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