Evidence map›Paper›PMID 39509012›Full record

ArticleSpine deformity2025

Preoperative anemia is associated with increased length of stay in adult spinal deformity surgery: evaluation of a large single-center patient cohort and future suggestions for patient optimization.

Mert Marcel Dagli, Connor A Wathen, Joshua L Golubovsky, Yohannes Ghenbot, John D Arena, Gabrielle Santangelo, Jonathan Heintz, Zarina S Ali, William C Welch, Jang W Yoon and 2 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Spine deformity, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Mert Marcel DagliDepartment of Neurosurgery, Perelman School of Medicine, University of Pennsylvania, 801 Spruce Street, Philadelphia, PA, 19107, USA. marcel.dagli@pennmedicine.upenn.edu.ORCID http://orcid.org/0000-0002-5201-6720
Connor A WathenDepartment of Neurosurgery, Perelman School of Medicine, University of Pennsylvania, 801 Spruce Street, Philadelphia, PA, 19107, USA.ORCID http://orcid.org/0000-0001-8291-7741
Joshua L GolubovskyDepartment of Neurosurgery, Perelman School of Medicine, University of Pennsylvania, 801 Spruce Street, Philadelphia, PA, 19107, USA.
Yohannes GhenbotDepartment of Neurosurgery, Perelman School of Medicine, University of Pennsylvania, 801 Spruce Street, Philadelphia, PA, 19107, USA.ORCID http://orcid.org/0000-0003-4382-9372
John D ArenaDepartment of Neurosurgery, Perelman School of Medicine, University of Pennsylvania, 801 Spruce Street, Philadelphia, PA, 19107, USA.
Gabrielle SantangeloDepartment of Neurosurgery, Perelman School of Medicine, University of Pennsylvania, 801 Spruce Street, Philadelphia, PA, 19107, USA.ORCID http://orcid.org/0000-0001-6948-5147
Jonathan HeintzBiostatistics Analysis Center, Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Zarina S AliDepartment of Neurosurgery, Perelman School of Medicine, University of Pennsylvania, 801 Spruce Street, Philadelphia, PA, 19107, USA.
William C WelchDepartment of Neurosurgery, Perelman School of Medicine, University of Pennsylvania, 801 Spruce Street, Philadelphia, PA, 19107, USA.ORCID http://orcid.org/0000-0002-1665-7985
Jang W YoonDepartment of Neurosurgery, Perelman School of Medicine, University of Pennsylvania, 801 Spruce Street, Philadelphia, PA, 19107, USA.ORCID http://orcid.org/0000-0003-2705-0406
Vincent ArletDepartment of Orthopaedic Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Ali K OzturkDepartment of Neurosurgery, Perelman School of Medicine, University of Pennsylvania, 801 Spruce Street, Philadelphia, PA, 19107, USA.ORCID http://orcid.org/0000-0001-6474-9422

Funding

Catherine Sharpe Foundation PG
6 · The paper itself

Abstract

purposeThis study aimed to investigate the relationship of preoperative hemoglobin levels as an independent prognostic factor for hospital and intensive care unit (ICU) length of stay (LOS) in patients undergoing surgery for adult spinal deformity (ASD), with the intent of determining whether there exists a correlation and enhancing patient preoperative optimization protocols.

methodsThe authors reviewed consecutive patients who underwent elective thoracolumbosacral posterior spinal fusion (PSF) involving six or more vertebrae for ASD from January 1, 2013, to December 13, 2021, with a minimum follow-up period of two years. This study primarily investigated the association of preoperative hemoglobin levels with hospital and ICU LOS. To analyze the data, both unadjusted and adjusted generalized linear models (GLM), incorporating cubic splines for non-linear variables, were applied.

resultsA total of 598 patients were included. GLMs for hospital and ICU LOS demonstrated nonlinear relationships with preoperative hemoglobin levels. Specifically, hospital LOS decreased with increasing preoperative hemoglobin until a significance threshold of 13.5 g/dl. Similarly, ICU LOS significantly decreased with increasing preoperative hemoglobin until 13.0 g/dl. Lower preoperative hemoglobin was associated with more perioperative transfusions, less likely discharge to home, and greater risk of reoperation.

conclusionsPreoperative anemia is an independent non-linear risk factor that significantly affects LOS, disposition, and outcomes after surgery for ASD. These findings advocate for a systemic preoperative approach and highlight the need for future research to improve postoperative outcomes and reduce hospital resource utilization. LEVEL OF EVIDENCE: IV.

Indexed as

AnemiaLength of StaySpinal CurvaturesSpinal FusionAdultAgedCohort StudiesFemaleHemoglobinsHumansIntensive Care UnitsMaleMiddle AgedPreoperative PeriodRetrospective StudiesRisk FactorsHemoglobinsAdultAnemiaBlood lossHemoglobinHumansIntensive care unitsLength of stayLinear modelsPrognosisRetrospective studiesSpinal curvaturesSpinal fusionSpineSurgical

Identifiers

PMID39509012
PMCPMC11893697

What Socratic holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.