Association of Alcohol Use Disorder and Perioperative Complications and Adverse Events After Spinal Fusion Surgery During the In-hospital Period: An Analysis of the National Inpatient Sample (NIS) Database

Ali M. Khan, Jacobs School of Medicine and Biomedical Sciences at University at Buffalo, Buffalo, New York, USA.
Mohamed A. Soliman, Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences at University at Buffalo, Buffalo, New York, USA; Department of Neurosurgery, Buffalo General Medical Center, Kaleida Health, Buffalo, New York, USA; Department of Neurosurgery, Faculty of Medicine, Cairo University, Cairo, Egypt.
Esteban Quiceno, Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences at University at Buffalo, Buffalo, New York, USA; Department of Neurosurgery, Buffalo General Medical Center, Kaleida Health, Buffalo, New York, USA.
Ahmed M. Elbayomy, Department of Neurological Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA.
Megan D. Malueg, Jacobs School of Medicine and Biomedical Sciences at University at Buffalo, Buffalo, New York, USA.
Alexander O. Aguirre, Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences at University at Buffalo, Buffalo, New York, USA; Department of Neurosurgery, Buffalo General Medical Center, Kaleida Health, Buffalo, New York, USA.
Cathleen C. Kuo, Jacobs School of Medicine and Biomedical Sciences at University at Buffalo, Buffalo, New York, USA.
Timothy J. Whelan, Jacobs School of Medicine and Biomedical Sciences at University at Buffalo, Buffalo, New York, USA.
Justin Im, Jacobs School of Medicine and Biomedical Sciences at University at Buffalo, Buffalo, New York, USA.
Hannon W. Levy, The George Washington University School of Medicine and Health Sciences, Washington DC, USA.
Asham Khan, Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences at University at Buffalo, Buffalo, New York, USA; Department of Neurosurgery, Buffalo General Medical Center, Kaleida Health, Buffalo, New York, USA.
John Pollina, Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences at University at Buffalo, Buffalo, New York, USA; Department of Neurosurgery, Buffalo General Medical Center, Kaleida Health, Buffalo, New York, USA.
Jeffrey P. Mullin, Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences at University at Buffalo, Buffalo, New York, USA; Department of Neurosurgery, Buffalo General Medical Center, Kaleida Health, Buffalo, New York, USA. Electronic address: jmullin@ubns.com.

Document Type

Journal Article

Publication Date

1-22-2025

Journal

World neurosurgery

DOI

10.1016/j.wneu.2025.123677

Keywords

Alcohol use disorder; complications; spinal fusion

Abstract

OBJECTIVE: Alcohol use disorder carries major effects shown to limit social support, increase recovery times, and lead to a higher incidence of surgical complications. This retrospective cohort study investigated the influence of AUD on perioperative outcomes and adverse events after spinal fusions in the largest sample size to date and spanning 11 years. METHODS: Data for adult (>18 years old) patients who underwent a spinal fusion as their primary surgery were identified from the Nationwide Inpatient Sample (NIS) database for the years 2009-2020. Patients were separated into an AUD cohort and a no AUD (control) cohort. Univariable and multivariable linear and logistic regression analyses were utilized to highlight statistically significant differences in their perioperative complications and adverse events. RESULTS: A total of 4,896,757 patients who underwent spinal fusion were identified. AUD was present in 97,565 (2.0%) patients, with the remaining patients serving as a control group. On multivariable analysis, patients with AUD had significantly increased odds of longer length of stay (odds ratio [OR]=3.40; 95% confidence interval [CI][3.24-3.57]p<0.001, and of the following perioperative complications and adverse events: neurologic injury (OR=3.24; 95% CI[3.05-3.44]p<0.001), respiratory-related (OR=3.06; 95% CI[2.91-3.21]p<0.001), systemic infectious (OR=2.79; 95% CI[2.48-3.13]p<0.001), neurologic (stroke) (OR=2.73; 95% CI[2.22-3.35])p<0.001, urinary-related (OR=2.23; 95% CI[2.11-2.36]p<0.001), venous thrombotic-related (OR=2.12; 95%[1.87-2.40]p<0.001), gastrointestinal-related (OR:1.91; 95% CI[1.79-2.03]p<0.001), wound-related (OR=2.32; 95% CI[2.10-2.56]p<0.001), cardiac-related (OR=1.44; 95% CI[1.34-1.55]p<0.001), and fusion disorders (OR=1.22; 95% CI[1.15-1.2]p<0.001). CONCLUSION: We found that AUD carries a significantly negative influence over perioperative outcomes and adverse events after spinal fusion in a large database population.

Department

School of Medicine and Health Sciences Student Works

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