The impact of Metabolic Syndrome (MetS) on 30-Day Outcomes Following Elective Anterior Cervical Discectomy and Fusions (ACDF)

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Study Design.

Retrospective review of prospective registry


To analyze the impact of metabolic syndrome (MetS) on 30-day outcomes following elective anterior cervical discectomy and fusions (ACDFs).

Summary of Background Data.

MetS is defined as the presence of a combination of hypertension, diabetes mellitus and obesity. Past literature has reported MetS to complicate post-operative care in patients undergoing various surgical procedures, including lumbar fusions.


The 2015–2016 American College of Surgeons-National Surgical Quality Improvement Program (ACS-NSQIP) database was queried using Current Procedural Terminology (CPT) codes 22551 (single-level) and 22552 (additional level). Patients undergoing disc arthroplasty, multi-level (>3) fusion, posterior cervical spine surgery, and patients with fracture, tumor, infection were excluded. MetS was defined using a pre-set criteria used by other NSQIP studies as the presence of - 1) diabetes mellitus AND 2) hypertension requiring medication AND 3) BMI≥30 kg/m2.


A total of 1,384 (8.8%) patients with MetS underwent a cervical fusion. Following adjusted analysis, results showed that presence of MetS was associated with higher odds of a prolonged length of stay ≥3 days (OR 1.32 [95% CI 1.12–1.56]; p = 0.001). No significant association was found between MetS and 30-day complications, 30-day reoperations, 30-day re-admissions, a non-home discharge and death.


While MetS was associated with a prolonged length of stay, its presence does not have a large impact on 30-day outcomes following elective ACDF.


Level of Evidence: 3

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