Corticosteroids may cause adverse outcomes in patients undergoing posterior lumbar surgery
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Long-term corticosteroid use is associated with significant increases in perioperative adverse outcomes for patients undergoing elective posterior lumbar surgery, according to published results.
Kareem J. Kebaish, MD, and colleagues from the department of orthopedics and rehabilitation at Yale School of Medicine used the National Surgical Quality Improvement Program database to identify 140,519 patients who underwent elective posterior lumbar spine surgery from 2005 to 2016.
According to the study, researchers compared patient factors, surgical factors and 30-day perioperative outcomes between patients who exhibited long-term corticosteroid use and patients who did not. Overall, 3.73% of the cohort (n = 5,243) had long-term corticosteroid use.
After propensity matching and multivariate analysis, Kebaish and colleagues found the long-term corticosteroid cohort had an increased risk for an adverse event (odds ratio = 1.45), a serious adverse event (OR = 1.57), a minor adverse event (OR = 1.47), infection (OR = 1.48), reoperation (OR = 1.48) and readmission (OR = 1.47) compared with the control cohort.
“With increasing numbers of patients taking such immunosuppressants and more patients undergoing posterior lumbar surgery, the effect of these drugs on the outcomes of elective posterior lumbar surgery is of clinical interest,” the researchers wrote in the study. “These findings can guide patient counseling and preemptive interventions before surgery for this patient population,” they added.
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