Preoperative Anemia Predicting Hospital Length of Stay Following Endoscopic Spine Surgery

Introduction: Endoscopic spine surgery (ESS) is a minimally invasive surgical technique used to treat spine pathologies and can offer significant relief for patients through pain and disability reduction. Preoperative anemia has been studied and has been associated with a longer hospital length of stay (LOS) in comparison to those who are hemodynamically stable. This study aims to investigate the role of preoperative anemia utilizing preoperative hemoglobin metrics in ESS, including the potential to utilize anemia status as a predictor of complications to inform physicians about the safety and efficacy of these procedures.

Methods: A single institution retrospective cohort study methodology was utilized to analyze endoscopic spine procedures from 2020 to 2023. The cohort was split into two sub-groups based on anemia status (normal hemoglobin vs low hemoglobin). T-tests were conducted for continuous variables and Chi-Squared tests were conducted for categorical variables.

Results: A total of 269 patients were included in our study. The population had a mean age of 55.6 ± 17.6 years, with an average BMI of 28.9 ± 5.9. On t-testing, there was a statistically significant association between preoperative hemoglobin values and total hospital LOS (1.28 vs 3.48 days, p < 0.01). There was also statistical significance between preoperative hemoglobin and LOS after surgery (0.39 vs 0.96 days, p < 0.01). There were no other significant correlations found on chi-square or logistic regression testing when considering preoperative hemoglobin to increase the risk of return to OR, readmission, persistent numbness/tingling, or overall postoperative complications following the procedure.

Conclusion : This study aimed to uncover correlations between preoperative anemia status and complications following ESS. A correlation between LOS, both total hospital LOS, and LOS after surgery until discharge, was discovered. The pathophysiology of this finding may involve the benefits of adequate oxygenation in healing and stabilization postoperatively, resulting in increased LOS for those with decreased hemoglobin. Further large multicenter prospective studies are needed to elucidate the correlation between anemia and LOS for ESS p as well as other potential complications and confounding variables