Do Obese and Extremely Obese Patients Lose Weight After Lumbar Spine Fusions?: Analysis of a Cohort of 7303 Patients From the Kaiser National Spine Registry

Paul T Akins; Maria Cs Inacio; Johannas A Bernbeck; Jessica Harris; Yuexin X Chen; Heather A Prentice; Kern H Guppy

doi:10.1097/BRS.0000000000002456

Do Obese and Extremely Obese Patients Lose Weight After Lumbar Spine Fusions? Analysis of a Cohort of 7303 Patients From the Kaiser National Spine Registry

Paul T Akins, Maria Cs Inacio, Johannas A Bernbeck, Jessica Harris, Yuexin X Chen, Heather A Prentice, Kern H Guppy

Registry Of Senior Australians Research Centre

Research output: Contribution to journal › Article › peer-review

7 Citations (Scopus)

Abstract

STUDY DESIGN: A retrospective cohort study from the Kaiser Permanente Spine Registry OBJECTIVE.: Determine whether obese and extremely obese patients with lumbar spine fusions lost a clinically significant amount of weight (> 5%) 1 year after their surgery SUMMARY OF BACKGROUND DATA.: Obesity in the United States has a prevalence of 35% and is a global health issue. Obesity is associated with lumbar spine disease. There is limited evidence regarding post-surgical weight loss after spine surgery.

METHODS: Adult patients in the Kaiser Permanente Spine Registry with lumbar fusions performed between 2009 and 2013 were included in the study sample (n = 7303). The outcome of interest was > 5% weight change 1 year post-operative from baseline. Three BMI groups were analyzed (BMI < 30; 30-39 obese; ≥40 extremely obese). Covariate analysis, multivariable logistic regression, odds ratios (OR) and 95% confidence intervals (CI) are provided.

RESULTS: At the time of spine surgery, 4456 (61%) had a BMI < 30, 2519 (34.5%) had a BMI between 30-39, 232 (3.2%) had a BMI≥40, and 96 (1.3%) were missing their intra-operative BMI. We observed the following weight loss pattern: BMI < 30, 11.1%; BMI 30-39, 16.6%; BMI>40, 21.1%. We observed the following weight gain pattern: BMI < 30, 15.6%; BMI 30-39, 12.7%; BMI>40, 9.5%. After risk-adjustment, obese and extremely obese patients were more likely to lose a clinically significant amount of weight 1 year after surgery (BMI 30-39: OR = 1.42, 95%CI 1.22-1.65; BMI≥40: OR = 1.73, 95%CI 1.21-2.47) compared to non-obese patients.

CONCLUSION: In this large cohort of patients with lumbar spinal fusions we observed more significant weight loss in obese and extremely obese patients compared to non-obese patients. Additional research is needed to determine whether this weight loss is due to improvements in back pain and increased physical activity.

LEVEL OF EVIDENCE: 3.

Original language	English
Journal	Spine
DOIs	https://doi.org/10.1097/BRS.0000000000002456
Publication status	E-pub ahead of print - 10 Oct 2017

Keywords

Journal Article

Access to Document

10.1097/BRS.0000000000002456

Cite this

@article{ea7b350a6e63405e9e0610465ada2356,

title = "Do Obese and Extremely Obese Patients Lose Weight After Lumbar Spine Fusions?: Analysis of a Cohort of 7303 Patients From the Kaiser National Spine Registry",

abstract = "STUDY DESIGN: A retrospective cohort study from the Kaiser Permanente Spine Registry OBJECTIVE.: Determine whether obese and extremely obese patients with lumbar spine fusions lost a clinically significant amount of weight (> 5%) 1 year after their surgery SUMMARY OF BACKGROUND DATA.: Obesity in the United States has a prevalence of 35% and is a global health issue. Obesity is associated with lumbar spine disease. There is limited evidence regarding post-surgical weight loss after spine surgery.METHODS: Adult patients in the Kaiser Permanente Spine Registry with lumbar fusions performed between 2009 and 2013 were included in the study sample (n = 7303). The outcome of interest was > 5% weight change 1 year post-operative from baseline. Three BMI groups were analyzed (BMI < 30; 30-39 obese; ≥40 extremely obese). Covariate analysis, multivariable logistic regression, odds ratios (OR) and 95% confidence intervals (CI) are provided.RESULTS: At the time of spine surgery, 4456 (61%) had a BMI < 30, 2519 (34.5%) had a BMI between 30-39, 232 (3.2%) had a BMI≥40, and 96 (1.3%) were missing their intra-operative BMI. We observed the following weight loss pattern: BMI < 30, 11.1%; BMI 30-39, 16.6%; BMI>40, 21.1%. We observed the following weight gain pattern: BMI < 30, 15.6%; BMI 30-39, 12.7%; BMI>40, 9.5%. After risk-adjustment, obese and extremely obese patients were more likely to lose a clinically significant amount of weight 1 year after surgery (BMI 30-39: OR = 1.42, 95%CI 1.22-1.65; BMI≥40: OR = 1.73, 95%CI 1.21-2.47) compared to non-obese patients.CONCLUSION: In this large cohort of patients with lumbar spinal fusions we observed more significant weight loss in obese and extremely obese patients compared to non-obese patients. Additional research is needed to determine whether this weight loss is due to improvements in back pain and increased physical activity.LEVEL OF EVIDENCE: 3.",

keywords = "Journal Article",

author = "Akins, {Paul T} and Inacio, {Maria Cs} and Bernbeck, {Johannas A} and Jessica Harris and Chen, {Yuexin X} and Prentice, {Heather A} and Guppy, {Kern H}",

year = "2017",

month = oct,

day = "10",

doi = "10.1097/BRS.0000000000002456",

language = "English",

journal = "Spine",

issn = "0362-2436",

publisher = "Lippincott Williams and Wilkins",

}

TY - JOUR

T1 - Do Obese and Extremely Obese Patients Lose Weight After Lumbar Spine Fusions?

T2 - Analysis of a Cohort of 7303 Patients From the Kaiser National Spine Registry

AU - Akins, Paul T

AU - Inacio, Maria Cs

AU - Bernbeck, Johannas A

AU - Harris, Jessica

AU - Chen, Yuexin X

AU - Prentice, Heather A

AU - Guppy, Kern H

PY - 2017/10/10

Y1 - 2017/10/10

N2 - STUDY DESIGN: A retrospective cohort study from the Kaiser Permanente Spine Registry OBJECTIVE.: Determine whether obese and extremely obese patients with lumbar spine fusions lost a clinically significant amount of weight (> 5%) 1 year after their surgery SUMMARY OF BACKGROUND DATA.: Obesity in the United States has a prevalence of 35% and is a global health issue. Obesity is associated with lumbar spine disease. There is limited evidence regarding post-surgical weight loss after spine surgery.METHODS: Adult patients in the Kaiser Permanente Spine Registry with lumbar fusions performed between 2009 and 2013 were included in the study sample (n = 7303). The outcome of interest was > 5% weight change 1 year post-operative from baseline. Three BMI groups were analyzed (BMI < 30; 30-39 obese; ≥40 extremely obese). Covariate analysis, multivariable logistic regression, odds ratios (OR) and 95% confidence intervals (CI) are provided.RESULTS: At the time of spine surgery, 4456 (61%) had a BMI < 30, 2519 (34.5%) had a BMI between 30-39, 232 (3.2%) had a BMI≥40, and 96 (1.3%) were missing their intra-operative BMI. We observed the following weight loss pattern: BMI < 30, 11.1%; BMI 30-39, 16.6%; BMI>40, 21.1%. We observed the following weight gain pattern: BMI < 30, 15.6%; BMI 30-39, 12.7%; BMI>40, 9.5%. After risk-adjustment, obese and extremely obese patients were more likely to lose a clinically significant amount of weight 1 year after surgery (BMI 30-39: OR = 1.42, 95%CI 1.22-1.65; BMI≥40: OR = 1.73, 95%CI 1.21-2.47) compared to non-obese patients.CONCLUSION: In this large cohort of patients with lumbar spinal fusions we observed more significant weight loss in obese and extremely obese patients compared to non-obese patients. Additional research is needed to determine whether this weight loss is due to improvements in back pain and increased physical activity.LEVEL OF EVIDENCE: 3.

AB - STUDY DESIGN: A retrospective cohort study from the Kaiser Permanente Spine Registry OBJECTIVE.: Determine whether obese and extremely obese patients with lumbar spine fusions lost a clinically significant amount of weight (> 5%) 1 year after their surgery SUMMARY OF BACKGROUND DATA.: Obesity in the United States has a prevalence of 35% and is a global health issue. Obesity is associated with lumbar spine disease. There is limited evidence regarding post-surgical weight loss after spine surgery.METHODS: Adult patients in the Kaiser Permanente Spine Registry with lumbar fusions performed between 2009 and 2013 were included in the study sample (n = 7303). The outcome of interest was > 5% weight change 1 year post-operative from baseline. Three BMI groups were analyzed (BMI < 30; 30-39 obese; ≥40 extremely obese). Covariate analysis, multivariable logistic regression, odds ratios (OR) and 95% confidence intervals (CI) are provided.RESULTS: At the time of spine surgery, 4456 (61%) had a BMI < 30, 2519 (34.5%) had a BMI between 30-39, 232 (3.2%) had a BMI≥40, and 96 (1.3%) were missing their intra-operative BMI. We observed the following weight loss pattern: BMI < 30, 11.1%; BMI 30-39, 16.6%; BMI>40, 21.1%. We observed the following weight gain pattern: BMI < 30, 15.6%; BMI 30-39, 12.7%; BMI>40, 9.5%. After risk-adjustment, obese and extremely obese patients were more likely to lose a clinically significant amount of weight 1 year after surgery (BMI 30-39: OR = 1.42, 95%CI 1.22-1.65; BMI≥40: OR = 1.73, 95%CI 1.21-2.47) compared to non-obese patients.CONCLUSION: In this large cohort of patients with lumbar spinal fusions we observed more significant weight loss in obese and extremely obese patients compared to non-obese patients. Additional research is needed to determine whether this weight loss is due to improvements in back pain and increased physical activity.LEVEL OF EVIDENCE: 3.

KW - Journal Article

U2 - 10.1097/BRS.0000000000002456

DO - 10.1097/BRS.0000000000002456

M3 - Article

C2 - 29019805

SN - 0362-2436

JO - Spine

JF - Spine

ER -