Brett Harwin, Blake Formanek, Mark Spoonamore, Djani Robertson, Zorica Buser, Jeffrey C. Wang


August 2019, Volume 28, Issue 9, pp 2070 - 2076 Original Article Read Full Article 10.1007/s00586-019-06072-4

First Online: 19 July 2019

The incidence of myocardial infarction after lumbar spine surgery

Purpose

As the population continues to age, the number of lumbar spine surgeries continues to increase. While there are many complications associated with lumbar surgeries, a myocardial infarction (MI) is a particularly devastating one. This complication is of considerable importance with mortality rates of postoperative MI documented between 26.5 and 70%. This study aimed to determine the relationship between lumbar surgeries, preoperative diagnoses (risk factors), and myocardial infarction.

Methods

Data from the Humana database (PearlDiver) were analyzed from 2007 to 2016. Patients undergoing lumbar spine surgeries were identified and stratified based on procedural approach, patient demographics, and preoperative risk factors. Each group was analyzed to determine the incidence and relative risk. Chi-square analysis was used to determine the significance.

Results

A total of 105,505 patients who fit inclusion criteria were identified in the PearlDiver database between 2007 and 2016. A total of 644 patients (0.63%) experienced a postoperative myocardial infarction within 30 days of surgery. Patients undergoing fusion and non-fusion procedures showed significantly different rates of postoperative myocardial infarction (0.08% vs. 0.05%, p < 0.01). Male patients, older patients, and patients with a Charlson comorbidity index > 3 showed a considerable increase in incidence (p < 0.01). Furthermore, patients with preoperative risk factors (high cholesterol, obesity, depression, congestive heart failure, hypertension, and hypotension) exhibited risk ratios from 0.01 to 1.85 (p < 0.01).

Conclusion

Preoperative risk factors, patient demographics, and procedure type had a significant effect on the incidence of postoperative myocardial infarction.

Graphic abstract

These slides can be retrieved under Electronic Supplementary Material.[Figure not available: see fulltext.]


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