Predictors of Postoperative Complications After Surgery for Lumbar Spinal Stenosis and Degenerative Lumbar Spondylolisthesis

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Introduction:The aim of this study was to determine the predictors of 30-day postoperative complications for surgical treatment of lumbar spinal stenosis with degenerative spondylolisthesis (LSSDS) in patients undergoing decompression and fusion or decompression alone.Methods:A retrospective review of 253 unique patients undergoing surgical intervention for LSSDS in the American College of Surgeons National Surgical Quality Improvement Program database was conducted.Results:The overall 30-day postoperative complication rate for the population was 16.6% (95% confidence interval [CI], 12.0% to 21.0%). Transfusions (8.9%), readmissions (5.9%), and unplanned returns to the OR (3.6%) were the most frequently observed complications across the population. ASA score and surgical time were found to be significant predictors of 30-day complications (ASA score: OR = 1.971; 95% CI, 1.077 to 3.609; P = 0.028; surgical time: OR = 1.006; 95% CI, 1.003 to 1.010; P < 0.001). Holding all other variables constant, multilevel cases, the inclusion of a fusion procedure, and body mass index were not found to be significant predictors of 30-day complications (P = 0.917, P = 0.464, and P = 0.572, respectively).Discussion and Conclusions:ASA score and OR time are leading indicators of complications, specifically for the LSSDS patient population. These are two easily attainable data points that are available for all surgical cases and could be used a clinical red flag for potential complications.

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