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.
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。