TY - JOUR
T1 - The Effect of Local Intraoperative Steroid Administration on the Rate of Post-Operative Dysphagia Following ACDF
T2 - A Study of 245,754 Patients
AU - Cancienne, Jourdan M.
AU - Werner, Brian C.
AU - Loeb, Alex E.
AU - Yang, Scott
AU - Hassanzadeh, Hamid
AU - Singla, Anuj
AU - Shen, Frank H.
AU - Shimer, Adam L.
PY - 2015/12/14
Y1 - 2015/12/14
N2 - STUDY DESIGN.: Retrospective database analysis OBJECTIVE.: To compare rates of postoperative dysphagia, length of stay, infection and wound complications following short and long ACDF in patients who received local intraoperative steroids and those who did not. SUMMARY OF BACKGROUND DATA.: Only one prior small institutional study has investigated the application of local steroids at the time of ACDF to decrease postoperative dysphagia. METHODS.: A large administrative database was utilized to compare rates of postoperative dysphagia, length of stay, and infectious complications within 90 days in patients who received local steroid following short (1–2 level) and long (3 or more level) ACDF and control groups who did not. Non obtainable information within the database included type of steroid, application technique, outcome data, and incidence of miscoding and non-coding by physicians. Odds ratios (OR), 95% confidence intervals (CI) and P values were then calculated using SPSS. RESULTS.: The incidence of dysphagia was significantly lower (9.0% vs 14.6%, p?=?0.005) in patients who received local steroid in the long ACDF group (n?=?322) compared to a control group who did not (n?=?45,432). This was not observed (p?=?0.198) in the short ACDF group who received steroid (n?=?1,770) compared to a control group who did not (n?=?198,230). The mean difference in length of stay was 1 day less for patients who received local steroid in both the short and long ACDF groups (p?<?0.0001). The combined rate of postoperative infection and wound complications was not significantly different between steroid and control groups (p?=?0.717). CONCLUSIONS.: This analysis of a large administrative database suggests that local intraoperative steroid is associated with a significantly reduced rate of postoperative dysphagia after long ACDF and reduced average length of stay following both long and short ACDF without any increase in the rate of postoperative infection or wound complication.Level of Evidence: 3
AB - STUDY DESIGN.: Retrospective database analysis OBJECTIVE.: To compare rates of postoperative dysphagia, length of stay, infection and wound complications following short and long ACDF in patients who received local intraoperative steroids and those who did not. SUMMARY OF BACKGROUND DATA.: Only one prior small institutional study has investigated the application of local steroids at the time of ACDF to decrease postoperative dysphagia. METHODS.: A large administrative database was utilized to compare rates of postoperative dysphagia, length of stay, and infectious complications within 90 days in patients who received local steroid following short (1–2 level) and long (3 or more level) ACDF and control groups who did not. Non obtainable information within the database included type of steroid, application technique, outcome data, and incidence of miscoding and non-coding by physicians. Odds ratios (OR), 95% confidence intervals (CI) and P values were then calculated using SPSS. RESULTS.: The incidence of dysphagia was significantly lower (9.0% vs 14.6%, p?=?0.005) in patients who received local steroid in the long ACDF group (n?=?322) compared to a control group who did not (n?=?45,432). This was not observed (p?=?0.198) in the short ACDF group who received steroid (n?=?1,770) compared to a control group who did not (n?=?198,230). The mean difference in length of stay was 1 day less for patients who received local steroid in both the short and long ACDF groups (p?<?0.0001). The combined rate of postoperative infection and wound complications was not significantly different between steroid and control groups (p?=?0.717). CONCLUSIONS.: This analysis of a large administrative database suggests that local intraoperative steroid is associated with a significantly reduced rate of postoperative dysphagia after long ACDF and reduced average length of stay following both long and short ACDF without any increase in the rate of postoperative infection or wound complication.Level of Evidence: 3
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U2 - 10.1097/BRS.0000000000001407
DO - 10.1097/BRS.0000000000001407
M3 - Article
C2 - 26679890
AN - SCOPUS:84950107908
SN - 0362-2436
JO - Spine
JF - Spine
ER -