Coagulation Laboratory Testing Is Predictive of Wound Complications Following Microdiscectomy

• Published in: Global spine journal Vol. 9; no. 2; pp. 138 - 142
• Main Authors: Goz, Vadim, Lakomkin, Nikita, Jalali, Ali, Brodke, Darrel S., Spiker, William R.
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA SAGE Publications 01.04.2019; Sage Publications Ltd
• Subjects: Laboratories; Original; elective surgery; preoperative labs; complications; outcomes; microdiscectomy
• ISSN: 2192-5682; 2192-5690
• DOI: 10.1177/2192568218764677

Study Design: Retrospective review. Objective: To determine whether abnormal preoperative testing is associated with postoperative complications in patients undergoing a microdiscectomy. Methods: Patients undergoing a microdiscectomy between 2006 and 2013 were identified in the National Surgical Quality Improvement Program database based on appropriate current procedural terminology coding. Thirty-day postoperative complications were analyzed in addition to patient demographics, comorbidities, and abnormal preoperative laboratory values. A series of over 650 univariate analyses to determine which independent variables to include for each complication were completed. Based on those analyses, 12 logistic regression models were built, one for each specific complication. Each model adjusted for age, gender, comorbidities, American Society of Anesthesiologists classification, as well as operative time. Results: A total of 5947 patients undergoing a microdiscectomy were included in the study. Abnormal preoperative international normalized ratio (odds ratio [OR] = 5.85, P < .05) was associated with any wound infection, superficial or deep, and abnormal partial thromboplastin time was significantly associated with wound dehiscence (OR = 6.80, P < .05). Postoperative urinary tract infections were associated with abnormal preoperative hematocrit (OR = 8.00, P < .05). None of the identified preoperative labs were independently associated with pulmonary embolism, organ space surgical site infections, or intubation. Conclusions: Abnormal preoperative coagulation labs were significantly associated with postoperative wound complications. However, the majority of tests were not associated with adverse events following microdiscectomy. Further study is necessary to conclude whether these tests provide information that can modify perioperative management and whether widespread testing is cost-effective.