title: Impact of Obesity on Outcomes in Adults Undergoing Elective Posterior Cervical Fusion.
abstract: METHODS
  Retrospective study of prospectively collected data.
  
  
  OBJECTIVE
  To determine the effect of obesity (body mass Index > 30) on postoperative morbidity and mortality after elective posterior cervical fusion in adults.
  
  
  BACKGROUND
  In those with spine disease, obesity has been shown to portend poorer general and disease-specific functional health status. The effect of obesity on outcomes after spine surgery, especially posterior cervical fusion, however, remains unclear. Previous studies have been contradictory to one another and largely limited by small sample sizes.
  
  
  METHODS
  The American College of Surgeons National Surgical Quality Improvement Program is a large multicenter clinical registry that prospectively collects preoperative risk factors, intraoperative variables, and 30-day postoperative morbidity and mortality outcomes from about 400 hospitals nationwide. Current Procedural Terminology codes were used to query the database for adults who underwent posterior cervical fusion between 2005 and 2012. Patients were separated into cohorts based on obesity status. Univariate analysis and multivariate logistic regression were used to analyze the effect of obesity on postoperative morbidity and mortality.
  
  
  RESULTS
  There was a significantly higher rate of only venous thromboembolism (VTE) in the obese group compared with nonobese cohort (3.5% vs. 0.6%, P = 0.015). On multivariate analysis, obesity was found to be an independent predictor (odds ratio 6.15; 95% confidence interval [CI], 1.26-30.20; P = 0.02) for VTE.
  
  
  CONCLUSIONS
  The present study demonstrated that patients with obesity can safely undergo posterior cervical fusion surgery. Although obesity predisposed to an elevated risk of VTE, postoperative mortality and morbidity were otherwise not significantly increased in this population.
  
  
  METHODS
  3.
authors.affiliation: NeuroSpine Surgery Research Group (NSURG), University of New South Wales (UNSW), Sydney, Australia.|Faculty of Medicine, University of New South Wales (UNSW), Sydney, Australia.
authors.forename: Kevin
authors.initials: K
authors.lastname: Phan
authors.affiliation: Department of Orthopedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY.
authors.forename: Parth
authors.initials: P
authors.lastname: Kothari
authors.affiliation: Department of Orthopedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY.
authors.forename: Nathan J
authors.initials: NJ
authors.lastname: Lee
authors.affiliation: NeuroSpine Surgery Research Group (NSURG), University of New South Wales (UNSW), Sydney, Australia.
authors.forename: Sohaib
authors.initials: S
authors.lastname: Virk
authors.affiliation: Department of Orthopedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY.
authors.forename: Jun S
authors.initials: JS
authors.lastname: Kim
authors.affiliation: Department of Orthopedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY.
authors.forename: Samuel K
authors.initials: SK
authors.lastname: Cho
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002574:Cervical Vertebrae / Q000601:surgery*; D017558:Elective Surgical Procedures / Q000009:adverse effects; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications*; D017063:Outcome Assessment, Health Care / Q000379:methods; D011183:Postoperative Complications / Q000209:etiology*; D012189:Retrospective Studies; D012307:Risk Factors; D013123:Spinal Fusion / Q000009:adverse effects; D054556:Venous Thromboembolism / Q000209:etiology*; D055815:Young Adult