The impacts of comorbid diseases on surgical and clinical outcomes in spondylolisthesis surgery

Yıl 2025, Cilt: 8 Sayı: 2, 167 - 173, 21.03.2025

Fahri Eryılmaz , Göker Yurdakul

https://doi.org/10.32322/jhsm.1604696

Öz

Aims: Management of comorbidities has a significant bearing on clinical outcomes from surgery, especially in the context of wound healing and pain management. This study aims to compare surgical patients with comorbidity (case group) and without (control group) based on recovery outcomes.
Methods: Surgical patients n=150 were enrolled patients in the case group (n=75), and control group (n=75). We collected and compared baseline demographic data, preoperative and postoperative pain levels based on the Visual Analogue Scale, discharge outcomes and assessment of wound healing. Factors affecting wound healing were evaluated using multivariate logistic regression, and predictors of postoperative pain were examined with multivariate linear regression.
Results: Demographic data revealed that the groups were comparable regarding age (p=0.122) and gender (p=0.758). The case group did have a higher mean body-mass index (BMI) of 28.9±3.4 than the control group mean BMI, which was 25.7±2.9; (p<0.001). Preoperative 7.5±1.2 vs 6.8±1.1, (p=0.001) and postoperative 4.8±1.5 vs 3.2±10, (p<0.001), pain scores were significantly greater in the case group. This is especially true for the case group, as only 40% were discharged in less than or equal to 24 hours compared with 73.3% of control (p<0.001). Cure of all wounds occurred in 90.7% of controls compared with 66.7% of cases (p<0.001), and delayed healing was significantly greater in cases (33.3% vs 9.3%, p=0.002). The case group had an odds ratio of 0.25 (p<0.001) for complete wound healing on multivariate analysis whereas group status, age, BMI and diabetes mellitus were significant postoperative pain predictors.
Conclusion: These findings highlight the need to direct resources towards preoperative evaluations before spondylolisthesis surgery and strategies in recovery after surgery for patients with diseases/disorders relevant to common problems seen.

Anahtar Kelimeler

Spondylolisthesis, comorbid diseases, wound healing, spine surgery

Spondilolistezis cerrahisinde eşlik eden hastalıkların cerrahi ve klinik sonuçlara etkileri

Öz

Amaç: Komorbiditelerin yönetimi, özellikle yara iyileşmesi ve ağrı yönetimi bağlamında, cerrahiden elde edilen klinik sonuçlar üzerinde önemli bir etkiye sahiptir. Bu çalışma komorbiditesi olan (vaka grubu) ve olmayan (kontrol grubu) cerrahi hastalarını iyileşme sonuçlarına göre karşılaştırmayı amaçlamaktadır.
Metod: Cerrahi hastalar N = 150 vaka grubuna (n=75) ve kontrol grubuna (n=75) kaydedildi. Temel demografik veriler, Görsel Analog Skalasına (VAS) dayalı preoperatif ve postoperatif ağrı düzeyleri, taburculuk sonuçları ve yara iyileşmesinin değerlendirilmesi toplandı ve karşılaştırıldı. Yara iyileşmesini etkileyen faktörler çok değişkenli lojistik regresyon kullanılarak değerlendirildi ve ameliyat sonrası ağrının belirleyicileri çok değişkenli doğrusal regresyon ile incelendi.
Bulgular: Demografik veriler, grupların yaş (p = 0.122) ve cinsiyet (p=0.758) açısından benzer olduğunu ortaya koydu. Vaka grubunun ortalama Vücut Kitle İndeksi (VKİ) 28.9±3.4 ile kontrol grubunun ortalama VKİ’si olan 25.7±2.9’dan daha yüksekti (p < 0:001). Preop (7.5 ± 1.2 vs 6.8 ± 1.1, p =0.001) ve postop 4.8 ± 1.5 vs 3.2 ± 10, p <0-001, ağrı skorları vaka grubunda anlamlı olarak daha yüksekti. Bu durum özellikle vaka grubu için geçerlidir, çünkü kontrol grubunun %73,3’üne kıyasla sadece %40’ı 24 saat veya daha kısa sürede taburcu edilmiştir (p < 0,001). Tüm yaraların iyileşmesi kontrol grubunda %90,7 iken vaka grubunda %66,7 olmuştur (p < 0,001) ve gecikmiş iyileşme vaka grubunda önemli ölçüde daha fazla olmuştur (%33,3’e karşı %9,3, p = 0,002). Çok değişkenli analizde, vaka grubunda tam yara iyileşmesi için odds oranı 0.25 (p < 0.001) iken, grup durumu, yaş, BMI ve diabetes mellitus ameliyat sonrası ağrının önemli belirleyicileriydi.
Sonuç: Bu bulgular, kaynakların spondilolistezis ameliyatı öncesi değerlendirmelere ve sık görülen sorunlarla ilgili hastalıkları / bozuklukları olan hastalar için ameliyat sonrası iyileşme stratejilerine yönlendirilmesi gerektiğini vurgulamaktadır.

Anahtar Kelimeler

spondilolistezis, komorbid hastalıklar, yara iyileşmesi, omurga cerrahisi

Kaynakça

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