Analysis of factors associated with polyuria in spinal surgery: a retrospective study

Intraoperative urine output monitoring is an important indicator to judge patient volume, and perioperative polyuria can lead to a variety of complications, which seriously affect the quality of prognosis of patients. Previous studies have found that intraoperative polyuria in some patients may be associated with the use of anesthetic drugs, especially in spinal surgery patients, where cases of polyuria have been reported more commonly. Therefore, this retrospective study focused on the factors influencing polyuria during spinal surgery.

Data from spine surgery patients in the Madison system of Tongji Hospital from September 2018 to December 2021 were collected. The age, sex, BMI, surgical information, preoperative and postoperative test results, LOS, and postoperative adverse reactions were extracted. The relevant data during the operation were recorded through the Madison system at the same time, including the time statistics of various types of surgery, the amount of liquid in and out of the operation, the use of anesthetic drugs, the use of vasoactive medications, and the results of blood gas analysis. The primary outcome was to analyze the factors influencing intraoperative polyuria. Secondary outcomes were analyzed, among adverse effects of intraoperative polyuria, etc. RESULTS: Among the 903 included patient data, we concluded that the factors influencing intraoperative polyuria were female (OR, 1.933, 95% CI, 1.457-2.565), dexmedetomidine (OR, 1.876, 95% CI, 1.338-2.631), dopamine (OR, 1.413, 95% CI, 1.406-1.910). At the same time, different surgical sites also affected the symptoms of polyuria (p < 0.001). Intraoperative polyuria symptoms led to an increase in the incidence of infection (p < 0.05) and secondary surgery (p < 0.05). The length of hospital stay was also increased (p < 0.05) compared with the normal urine output group. There was no significant difference in the time of operation and preoperative and postoperative examination information(p > 0.05).

Females, dexmedetomidine, dopamine may be risk factors for intraoperative polyuria. Intraoperative polyuria will lead to various postoperative adverse reactions, increasing the proportion of postoperative infection and secondary surgery.