Perioperative Retinal Artery Occlusion: Incidence and Risk Factors in Spinal Fusion Surgery From the US National Inpatient Sample 1998-2013.

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Title Perioperative Retinal Artery Occlusion: Incidence and Risk Factors in Spinal Fusion Surgery From the US National Inpatient Sample 1998-2013.
Creator Tyler Calway; Daniel S. Rubin; Heather E. Moss; Charlotte E. Joslin; Ankit I. Mehta; Steven Roth
Affiliation Rosalind Franklin University Medical School (TC), North Chicago, Illinois; Department of Anesthesia and Critical Care (DSR), the University of Chicago Medicine, Chicago, Illinois; Departments of Ophthalmology and Visual Science (HEM, SR), Neurology and Rehabilitation (HEM), Neurosurgery (AIM), and Anesthesiology (SR), College of Medicine, University of Illinois at Chicago, Chicago, Illinois; Dr. Moss is now with Department of Ophthalmology, Stanford University, Palo Alto, California; Department of Ophthalmology and Visual Science (CEJ), College of Medicine, and School of Epidemiology and Public Health, University of Illinois at Chicago, Chicago, Illinois; and Department of Anesthesia and Critical Care (SR), University of Chicago, Chicago, Illinois
Subject Retinal Artery Occlusion; Spinal Fusion Surgery
Abstract Retinal artery occlusion (RAO) is a rare but devastating complication of spinal fusion surgery. We aimed to determine its incidence and associated risk factors. Hospitalizations involving spinal fusion surgery were identified by searching the National Inpatient Sample, a database of hospital discharges, from 1998 to 2013. RAO cases were identified using ICD-9-CM codes. Using the STROBE guidelines, postulated risk factors were chosen based on literature review and identified using ICD-9-CM codes. Multivariate logistic models with RAO as outcome, and risk factors, race, age, admission, and surgery type evaluated associations. Of an estimated 4,784,275 spine fusions in the United States from 1998 to 2013, there were 363 (CI: 291-460) instances of RAO (0.76/10,000 spine fusions, CI: 0.61-0.96). Incidence ranged from 0.35/10,000 (CI: 0.11-1.73) in 2001-2002 to 1.29 (CI: 0.85-2.08) in 2012-2013, with no significant trend over time (P = 0.39). Most strongly associated with RAO were stroke, unidentified type (odds ratio, OR: 14.33, CI: 4.54-45.28, P < 0.001), diabetic retinopathy (DR) (OR: 7.00, CI: 1.18-41.66, P = 0.032), carotid stenosis (OR: 4.94, CI: 1.22-19.94, P = 0.025), aging (OR for age 71-80 years vs 41-50 years referent: 4.07, CI: 1.69-10.84, P = 0.002), and hyperlipidemia (OR: 2.96, CI: 1.85-4.73, P < 0.001). There was an association between RAO and transforaminal lumbar interbody fusion (OR: 2.95, CI: 1.29-6.75, P = 0.010). RAO was more likely to occur with spinal surgery performed urgently or emergently compared with being done electively (OR: 0.40, CI: 0.23-0.68, P < 0.001).; Patient-specific associations with RAO in spinal fusion include aging, carotid stenosis, DR, hyperlipidemia, stroke, and specific types of surgery. DR may serve as an observable biomarker of heightened risk of RAO in patients undergoing spine fusion.
OCR Text Show
Publisher Lippincott, Williams & Wilkins
Date 2018-03
Type Text
Source Journal of Neuro-Ophthalmology, December 2018, Volume 38, Issue 1
Language eng
Rights Management © North American Neuro-Ophthalmology Society
Publication Type Journal Article
ARK ark:/87278/s6z36bw9
Setname ehsl_novel_jno
Date Created 2019-03-11
Date Modified 2019-03-11
ID 1404069
Reference URL https://collections.lib.utah.edu/ark:/87278/s6z36bw9
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