{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T19:20:34Z","timestamp":1787772034136,"version":"build-2784847793"},"reference-count":26,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,1]]},"abstract":"ABSTRACT<\/jats:title>\n \n Background:<\/jats:title>\n With the increasing amount of elective spine fusion patients presenting with cardiac disease and congestive heart failure, it is becoming difficult to assess when it is safe to proceed with surgery. Assessing the severity of heart failure (HF) through ejection fraction may provide insight into patients\u2019 short- and long-term risks.<\/jats:p>\n <\/jats:sec>\n \n Purpose:<\/jats:title>\n The purpose of this study was to assess the severity of HF on perioperative outcomes of spine fusion surgery patients.<\/jats:p>\n <\/jats:sec>\n \n Study Design\/Setting:<\/jats:title>\n This was a retrospective cohort study of the PearlDiver database.<\/jats:p>\n <\/jats:sec>\n \n Patient Sample:<\/jats:title>\n We enrolled 670,526 patients undergoing spine fusion surgery.<\/jats:p>\n <\/jats:sec>\n \n Outcome Measures:<\/jats:title>\n Thirty-day and 90-day complication rates, discharge destination, length of stay (LOS), physician reimbursement, and hospital costs.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n \n Patients undergoing elective spine fusion surgery were isolated and stratified by preoperative HF with preserved ejection fraction (P-EF) or reduced ejection fraction (R-EF) (International Classification of Diseases-9: 428.32 [chronic diastolic HF] and 428.22 [chronic systolic HF]). Means comparison tests (Chi-squared and independent samples t-tests, as appropriate) compared differences in demographics, diagnoses, comorbidities, procedural characteristics, LOS, 30-day and 90-day complication outcomes, and total hospital charges between those diagnosed with P-EF and those not R-EF. Binary logistic regression assessed the odds of complication associated with HF, controlling for levels fused (odds ratio [OR] [95% confidence interval]). Statistical significance was set at\n P<\/jats:italic>\n < 0.05.\n <\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n Totally 670,526 elective spine fusion patients were included. Four thousand and seventy-seven were diagnosed with P-EF and 2758 R-EF. Overall, P-EF patients presented with higher rates of morbid obesity, chronic kidney disease, chronic obstructive pulmonary disease, diabetes mellitus, and hypertension (all\n P<\/jats:italic>\n < 0.001). In relation to No-HF, P-EF patients had higher rates of 30-day major complications including pulmonary embolism, pneumonia, cerebrovascular accident (CVA), myocardial infarctions (MI), sepsis, and death (all\n P<\/jats:italic>\n < 0.001). Furthermore, P-EF was associated significantly with increased odds of pneumonia (OR: 2.07 [1.64\u20132.56],\n P<\/jats:italic>\n < 0.001) and sepsis (OR: 2.09 [1.62\u20132.66],\n P<\/jats:italic>\n < 0.001). Relative to No-HF, R-EF was associated with significantly higher odds of MI (OR: 3.66 [2.34\u20135.47]), CVA (OR: 2.70 [1.67\u20134.15]), and pneumonia (OR: 1.85 [1.40\u20132.40]) (all\n P<\/jats:italic>\n < 0.001) postoperative within 30 days. Adjusting for prior history of MI, CAD, and the presence of a pacemaker R-EF was a significant predictor of an MI 30 days postoperatively (OR: 2.2 [1.14\u20134.32],\n P<\/jats:italic>\n = 0.021). Further adjusting for history of CABG or stent placement, R-EF was associated with higher odds of CVA (OR: 2.11 [1.09\u20134.19],\n P<\/jats:italic>\n = 0.028) and MI (OR: 2.27 [1.20\u20134.43],\n P<\/jats:italic>\n = 0.013).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions:<\/jats:title>\n When evaluating the severity of HF before spine surgery, R-EF was associated with a higher risk of major complications, especially the occurrence of a myocardial infarction 30 days postoperatively. During preoperative risk assessment, congestive HF should be considered thoroughly when thinking of postoperative outcomes with emphasis on R-EF.<\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/jcvjs.jcvjs_186_23","type":"journal-article","created":{"date-parts":[[2024,3,13]],"date-time":"2024-03-13T07:03:19Z","timestamp":1710313399000},"page":"45-52","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Impact of congestive heart failure on patients undergoing lumbar spine fusion for adult spine deformity"],"prefix":"10.4103","volume":"15","author":[{"given":"Oluwatobi O.","family":"Onafowokan","sequence":"first","affiliation":[{"name":"Department of Orthopedic and Neurologic Surgery, New York Spine Institute, NYU Langone Orthopedic Hospital, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Waleed","family":"Ahmad","sequence":"additional","affiliation":[{"name":"Department of Orthopedic and Neurologic Surgery, New York Spine Institute, NYU Langone Orthopedic Hospital, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kimberly","family":"McFarland","sequence":"additional","affiliation":[{"name":"Department of Orthopedic and Neurologic Surgery, New York Spine Institute, NYU Langone Orthopedic Hospital, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tyler K.","family":"Williamson","sequence":"additional","affiliation":[{"name":"Department of Orthopedic and Neurologic Surgery, New York Spine Institute, NYU Langone Orthopedic Hospital, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Tretiakov","sequence":"additional","affiliation":[{"name":"Department of Orthopedic and Neurologic Surgery, New York Spine Institute, NYU Langone Orthopedic Hospital, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jamshaid M.","family":"Mir","sequence":"additional","affiliation":[{"name":"Department of Orthopedic and Neurologic Surgery, New York Spine Institute, NYU Langone Orthopedic Hospital, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ankita","family":"Das","sequence":"additional","affiliation":[{"name":"Department of Orthopedic and Neurologic Surgery, New York Spine Institute, NYU Langone Orthopedic Hospital, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua","family":"Bell","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, University of Virginia School of Medicine, Charlottesville, VA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Naessig","sequence":"additional","affiliation":[{"name":"Department of Orthopedic and Neurologic Surgery, New York Spine Institute, NYU Langone Orthopedic Hospital, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shaleen","family":"Vira","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, UT Southwestern Medical Center, Dallas, TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Virginie","family":"Lafage","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Hospital for Special Surgery, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carl","family":"Paulino","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, SUNY Downstate Medical Center, Brooklyn, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bassel","family":"Diebo","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Warren Alpert Medical School of Brown University, RI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Schoenfeld","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Harvard Medical School, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hamid","family":"Hassanzadeh","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, University of Virginia School of Medicine, Charlottesville, VA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pawel P.","family":"Jankowski","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Hoag Neurosciences Institute, Irvine, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aaron","family":"Hockley","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Alberta, Calgary, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter Gust","family":"Passias","sequence":"additional","affiliation":[{"name":"Department of Orthopedic and Neurologic Surgery, New York Spine Institute, NYU Langone Orthopedic Hospital, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2024,3,13]]},"reference":[{"key":"R1-20240904","doi-asserted-by":"crossref","first-page":"3272","DOI":"10.1093\/cvr\/cvac013","article-title":"Global burden of heart failure: A comprehensive and updated review of epidemiology","volume":"118","author":"Savarese","year":"2023","journal-title":"Cardiovasc Res"},{"key":"R2-20240904","doi-asserted-by":"crossref","first-page":"672","DOI":"10.1111\/echo.12116","article-title":"Assessment of left ventricular size and function during cardiac surgery. 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