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Elevated Serum Alkaline Phosphatase is an Independent Predictor of Complications After Lumbar Spinal Fusion.
Chan, Justin P; Lung, Brandon; Donnelly, Megan; Hashmi, Sohaib Z; Bhatia, Nitin; Lee, Yu-Po.
Afiliación
  • Chan JP; University of California Irvine, Department of Orthopedic Surgery, Orange, California, USA. Electronic address: jprchan@hs.uci.edu.
  • Lung B; University of California Irvine, Department of Orthopedic Surgery, Orange, California, USA.
  • Donnelly M; University of California Irvine, Department of Orthopedic Surgery, Orange, California, USA.
  • Hashmi SZ; University of California Irvine, Department of Orthopedic Surgery, Orange, California, USA.
  • Bhatia N; University of California Irvine, Department of Orthopedic Surgery, Orange, California, USA.
  • Lee YP; University of California Irvine, Department of Orthopedic Surgery, Orange, California, USA.
World Neurosurg ; 188: e434-e440, 2024 Aug.
Article en En | MEDLINE | ID: mdl-38810876
ABSTRACT

BACKGROUND:

Alkaline phosphatase (ALP) is an enzyme which has been proven useful as a biomarker for bone turnover and inflammation. We hypothesized that high serum ALP levels are associated with increased complication rates following lumbar spinal fusion.

METHODS:

Lumbar spinal fusion procedures from 2005 to 2019 were queried from the National Surgical Quality Improvement Program (NSQIP) database. Serum alkaline phosphatase levels were stratified into low <44 IU/L, normal 44-147 IU/L, and high >147 IU/L. A risk-adjusted multivariate logistic regression was used to analyze ALP as an independent risk factor for complications.

RESULTS:

A total of 16,441 patients who underwent lumbar fusion procedures were included. Adjusted multivariate logistic regression analysis demonstrated that patients with a high serum ALP level had a significantly increased risk for developing septic shock (OR 4.68, 95% CI 1.83-11.97), pneumonia (OR 2.89, 95% CI 1.59-5.25), requiring a transfusion (OR 2.09, 95% CI 1.68-2.59), reoperation within 30 days (OR 1.68, 95% CI 1.12-2.52), readmission within 30 days (OR 1.60, 95% CI 1.16-2.21), increased length of stay (OR 1.87, 95% CI 1.49-2.36), and nonhome discharge (OR 2.18, 95% CI 1.80-2.66).

CONCLUSIONS:

Elevated serum ALP in patients undergoing lumbar fusion procedures is associated with increased risk for multiple in-hospital complications as well as higher rates of readmission and reoperation.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Complicaciones Posoperatorias / Fusión Vertebral / Fosfatasa Alcalina / Vértebras Lumbares Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: World Neurosurg Asunto de la revista: NEUROCIRURGIA Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
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XML
PubMed Links
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Complicaciones Posoperatorias / Fusión Vertebral / Fosfatasa Alcalina / Vértebras Lumbares Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: World Neurosurg Asunto de la revista: NEUROCIRURGIA Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos