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Does cognition status affect spinal surgery outcomes: a systematic review and meta-analysis.
Ahmed Ashraf1, Janesh Karnati1, Xu Tao1
1Department of Neurological Surgery, University of Cincinnati College of Medicine, Cincinnati OH, USA; Spine Translational and Aging Laboratory, University of Cincinnati College of Medicine, Cincinnati OH, USA.
Summary
Cognitive impairment (CI) significantly increases risks for spine surgery complications like delirium and infections. Early CI management may improve patient outcomes and reduce hospital resource use.
Area of Science:
- Neurosurgery
- Geriatrics
- Public Health
Background:
- Cognitive impairment (CI) is an independent risk factor for adverse outcomes following spine surgery.
- No prior systematic review has comprehensively assessed the impact of CI on spine surgery results.
Purpose of the Study:
- To conduct a systematic review and meta-analysis evaluating perioperative outcomes and facility-based measures in patients with CI undergoing spine surgery.
Main Methods:
- Systematic literature search of PubMed, Embase, Cochrane Library, and Web of Science.
- Inclusion of 11 studies with 16,070 patients, analyzing various postoperative outcomes.
- Random-effect model meta-analysis and subgroup analyses for lumbar and cervical spine procedures.
Main Results:
- Patients with CI exhibited significantly higher odds of developing urinary tract infections (UTI), delirium, deep vein thrombosis (DVT), pneumonia, wound dehiscence, and sepsis.
- CI was associated with a twofold increase in intensive care unit (ICU) admission and a 20% higher likelihood of 30-day readmission.
Conclusions:
- Preoperative cognitive impairment is linked to poorer postoperative health outcomes and inferior facility-based measures after spine surgery.
- Early identification and management of CI are crucial for mitigating risks and enhancing patient outcomes.
