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Patients with RA and Fusion Surgery Complications
Spine J; ePub 2018 Apr 6; Bernstein, Kurucan, et al
Patients with rheumatoid arthritis (RA) have an increased number of comorbidities and complication rate compared to patients without RA, according to a recent study. Therefore, such knowledge can help surgeons and patients with RA have beneficial preoperative discussions regarding outcomes. Using the Nationwide Inpatient Sample (NIS) from 2013-2014, researchers identified 52,818 adult spinal deformity patients undergoing non-cervical spine fusions (1,814 patients with RA and 51,004 patients without RA). They found:
- Patients with RA were older, were more likely to be women, had increased rates of osteoporosis, had a greater percentage of their surgeries reimbursed by Medicare, and more often had weekend admissions.
- Patients with RA had higher rates of iron deficiency anemia, congestive heart failure, chronic pulmonary disease, depression, and fluid and electrolyte disorders.
- Patients without RA had higher rates of alcohol abuse.
- Total complications were greater in patients with RA.
- Patients with RA had higher rates of infection, implant-related complications, incidental durotomies, and urinary tract infections.
Bernstein DN, Kurucan E, Menga EN, Molinari RW, Rubery PT, Mesfin A. Comparison of adult spinal deformity patients with and without rheumatoid arthritis undergoing primary non-cervical fusion surgery: A nationwide analysis of 52,818 patients. [Published online ahead of print April 6, 2018]. Spine J. doi:10.1016/j.spinee.2018.03.020.