Abstract：
Hereditary hemochromatosis (HH) is a common autosomal recessive disorder. This disease affects gut iron transport, leading to iron overload, which affects immune function, coagulation mechanics, and bone health. Within the spine, HH contributes to decreased bone mineral density and accelerated intervertebral disc degeneration. The purpose of this study was to discover the differences in the rates of common 90-day postoperative complications and 1-year and 2-year surgical outcomes in patients with and without HH after anterior cervical discectomy and fusion (ACDF).
Using the PearlDiver database, patients with active diagnoses of HH before ACDF were matched to patients without HH using a 1:5 ratio on the basis of age, sex, body mass index, and comorbidities. Postoperative complications were assessed at 90 days, and 1-year and 2-year surgical outcomes were assessed. All outcomes and complications were analyzed using multivariate logistic regression with significance achieved at P < 0.05.
Patients with HH had significantly higher rates of 1-year and 2-year reoperation rates compared with patients without HH (29.19% vs. 3.94% and 37.1% vs. 5.93%, respectively; P < 0.001). The rates of 90-day postoperative complications significantly increased in patients with HH including dysphagia, pneumonia, cerebrovascular accident, deep vein thrombosis, acute kidney injury, urinary tract infection, hyponatremia, surgical site infection, iatrogenic deformity, emergency department visit, and hospital readmission.
Patients with HH undergoing ACDF showed increased 90-day postoperative complications and significantly increased rates of 1-year and 2-year reoperation compared with patients without HH. These findings suggest that iron overload may contribute to adverse outcomes in patients with HH undergoing 1-level and 2-level ACDF.
Using the PearlDiver database, patients with active diagnoses of HH before ACDF were matched to patients without HH using a 1:5 ratio on the basis of age, sex, body mass index, and comorbidities. Postoperative complications were assessed at 90 days, and 1-year and 2-year surgical outcomes were assessed. All outcomes and complications were analyzed using multivariate logistic regression with significance achieved at P < 0.05.
Patients with HH had significantly higher rates of 1-year and 2-year reoperation rates compared with patients without HH (29.19% vs. 3.94% and 37.1% vs. 5.93%, respectively; P < 0.001). The rates of 90-day postoperative complications significantly increased in patients with HH including dysphagia, pneumonia, cerebrovascular accident, deep vein thrombosis, acute kidney injury, urinary tract infection, hyponatremia, surgical site infection, iatrogenic deformity, emergency department visit, and hospital readmission.
Patients with HH undergoing ACDF showed increased 90-day postoperative complications and significantly increased rates of 1-year and 2-year reoperation compared with patients without HH. These findings suggest that iron overload may contribute to adverse outcomes in patients with HH undergoing 1-level and 2-level ACDF.
摘要：
背景：遗传性血色素沉着病（HH）是一种常见的常染色体隐性遗传疾病。这种疾病影响肠道铁运输，导致铁过载，影响免疫功能，凝固力学,骨骼健康。在脊柱内，HH有助于降低骨密度和加速椎间盘退变。这项研究的目的是发现颈前路椎间盘切除术和融合术（ACDF）后有和没有遗传性血色素沉着症的患者的常见术后90天并发症发生率以及1年和2年手术结果的差异。
方法：利用PearlDiver数据库，在ACDF之前主动诊断为HH的患者与非HH患者使用1:5的年龄比例进行匹配，性别,BMI,和合并症。术后并发症在90天进行评估，评估了1年和2年的手术结局.所有结果和并发症均采用多因素logistic回归分析，P<0.05。
结果：与没有HH的患者相比，HH的患者一年和两年的再手术率明显更高（29.19％vs.3.94%和37.1%vs.5.93%,分别；P<0.001)。HH患者术后90天并发症的发生率显着增加，包括吞咽困难，肺炎,CVA,DVT,AKI,UTI,低钠血症,SSI,医源性畸形,ED访问,再入院。
结论：与非HH患者相比，接受ACDF的HH患者术后90天并发症增加，1年和2年再手术率显著增加。这些发现表明，铁超负荷可能导致接受一水平和两水平ACDF的HH患者的不良后果。
方法：利用PearlDiver数据库，在ACDF之前主动诊断为HH的患者与非HH患者使用1:5的年龄比例进行匹配，性别,BMI,和合并症。术后并发症在90天进行评估，评估了1年和2年的手术结局.所有结果和并发症均采用多因素logistic回归分析，P<0.05。
结果：与没有HH的患者相比，HH的患者一年和两年的再手术率明显更高（29.19％vs.3.94%和37.1%vs.5.93%,分别；P<0.001)。HH患者术后90天并发症的发生率显着增加，包括吞咽困难，肺炎,CVA,DVT,AKI,UTI,低钠血症,SSI,医源性畸形,ED访问,再入院。
结论：与非HH患者相比，接受ACDF的HH患者术后90天并发症增加，1年和2年再手术率显著增加。这些发现表明，铁超负荷可能导致接受一水平和两水平ACDF的HH患者的不良后果。
