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Postoperative Outcomes Among Dialysis Patients Undergoing Surgery for Cervical Spine Trauma
Muhammad Zulfiqar1, Ved A Vengsarkar1,2, Elizabeth Driskill1
1Department of Orthopaedic Surgery, University of Virginia, Charlottesville, VA.
Study Design:
A retrospective cohort study using a large, de-identified database.
Objective:
To evaluate the impact of dialysis on short-term complications and long-term outcomes in patients with chronic kidney disease (CKD) undergoing surgery for cervical spine trauma.
Summary Of Background Data:
It is established that patients with advanced CKD are at higher risk of postoperative morbidity and mortality after surgery. The impact of dialysis on postoperative complications among patients with chronic kidney disease (CKD) undergoing surgery specifically for cervical spine trauma is not well understood.
Methods:
A retrospective cohort study was conducted using a database to evaluate the impact of dialysis on rates of short-term complications after cervical spine trauma surgery and assess long-term outcomes in dialysis versus non-dialysis patients. Multivariable logistic regression was used to compare these rates.
Results:
After adjusting for baseline comorbidities, dialysis patients were found to have higher rates of cardiac arrest, surgical site infections, and pressure ulcers compared with non-dialysis patients. In addition, dialysis patients had higher rates of emergency department visits at one and three months postoperatively, as well as higher two-year mortality.
Conclusion:
Dialysis is associated with significantly increased risks of postoperative complications, health care utilization, and long-term mortality in patients undergoing surgery for cervical spine trauma. Further investigations are needed to determine the impact of dialysis timing in the perioperative setting and optimization strategies to mitigate risks in this vulnerable population.
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