Risk Factors for Post-Spinal Fusion Visual Loss Identified

Include gender, obesity, Wilson frame use, anesthesia time, blood loss, percent colloid given

TUESDAY, Dec. 27 (HealthDay News) -- Significant risk factors for ischemic optic neuropathy (ION) after spinal fusion surgery include male gender, obesity, Wilson frame use, longer anesthetic duration, greater estimated blood loss, and lower percent colloid administration, according to a study published in the January issue of Anesthesiology.

Lorri A. Lee, M.D., from the University of Washington in Seattle, and colleagues investigated the risk factors for ION after spinal fusion surgery. In a case-control study, 80 adult patients with ION from the American Society of Anesthesiologists Postoperative Visual Loss Registry were compared with 315 randomly selected adult controls without post-spinal fusion surgery ION, matched by year of surgery. Stepwise multivariate analysis was used to evaluate preexisting medical conditions and perioperative factors that might predict ION in patients and controls.

The investigators found that, following spinal fusion surgery, significant risk factors for ION included male gender, obesity, and Wilson frame use (odds ratios [ORs], 2.53, 2.83, and 4.30, respectively), anesthesia duration (OR per one hour, 1.39), estimated blood loss (OR per 1 liter, 1.34), and colloid as a percent of nonblood replacement (OR per 5 percent, 0.67). The area under the curve, sensitivity, and specificity after cross-validation were 0.85, 0.79, and 0.82, respectively.

"Prediction tables for ION based on this study may help inform patients, surgeons, and anesthesiologists of the absolute and relative risk for patients developing ION, and guide decision-making," the authors write.

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