TY - JOUR
T1 - Early Diet Liberalization After Anterior Lumbar Interbody Fusion Improves Postoperative Recovery
AU - Bridges, Tiffany
AU - Meade, Matthew
AU - Brush, Parker
AU - Lee, Yunsoo
AU - Narayanan, Rajkishen
AU - McCurdy, Michael A.
AU - Lambrechts, Mark
AU - Charlton, Alex
AU - Jenkins, Eleanor
AU - Juniewicz, Robert
AU - Destine, Henson
AU - Kaye, Ian David
AU - Kurd, Mark
AU - Canseco, Jose
AU - Hilibrand, Alan
AU - Vaccaro, Alexander R.
AU - Schroeder, Gregory
AU - Kepler, Christopher
N1 - Publisher Copyright:
© The Author(s) 2023.
PY - 2023
Y1 - 2023
N2 - Study Design: Retrospective Cohort Study. Objectives: The objective of this study was to assess the impact of diet liberalization on short-term outcomes in patients undergoing anterior interbody lumbar fusion (ALIF). Methods: A retrospective review was performed for patients undergoing ALIF at our tertiary care center institution from 2010 to 2022. Electronic medical records were reviewed for demographics, surgical characteristics, and 90-day postoperative outcomes. Results: We included 515 patients in this study with 102 patients receiving a full diet on the same day as their operation. All other patients had a delay of at least 1 day (average 1.6 days) until a full diet was provided. This group was found to have a higher rate of postoperative ileus (10.2% vs 2.9%) and urinary retention (16.0% vs 3.9%). The readmission rate and percent of patients presenting to the emergency department within 90 days postoperatively were similar. On multivariate regression analysis, same-day, full-diet patients had decreased odds of developing urinary retention (OR =.17) and a shorter length of hospital stay (Estimate: −.99). Immediate full diet had no impact on the development of ileus (OR:.33). Conclusions: An immediate postoperative full diet following an anterior approach to the lumbar spine was not found to be associated with an increased risk of postoperative ileus in patients deemed appropriate for early diet liberalization. Moreover, an early full diet was found to reduce length of hospitalization and risk of postoperative urinary retention. Reconsideration of postoperative diet protocols may help optimize patient outcomes and recovery.
AB - Study Design: Retrospective Cohort Study. Objectives: The objective of this study was to assess the impact of diet liberalization on short-term outcomes in patients undergoing anterior interbody lumbar fusion (ALIF). Methods: A retrospective review was performed for patients undergoing ALIF at our tertiary care center institution from 2010 to 2022. Electronic medical records were reviewed for demographics, surgical characteristics, and 90-day postoperative outcomes. Results: We included 515 patients in this study with 102 patients receiving a full diet on the same day as their operation. All other patients had a delay of at least 1 day (average 1.6 days) until a full diet was provided. This group was found to have a higher rate of postoperative ileus (10.2% vs 2.9%) and urinary retention (16.0% vs 3.9%). The readmission rate and percent of patients presenting to the emergency department within 90 days postoperatively were similar. On multivariate regression analysis, same-day, full-diet patients had decreased odds of developing urinary retention (OR =.17) and a shorter length of hospital stay (Estimate: −.99). Immediate full diet had no impact on the development of ileus (OR:.33). Conclusions: An immediate postoperative full diet following an anterior approach to the lumbar spine was not found to be associated with an increased risk of postoperative ileus in patients deemed appropriate for early diet liberalization. Moreover, an early full diet was found to reduce length of hospitalization and risk of postoperative urinary retention. Reconsideration of postoperative diet protocols may help optimize patient outcomes and recovery.
KW - anterior lumbar interbody fusion
KW - diet
KW - early diet
KW - postoperative ileus
UR - http://www.scopus.com/inward/record.url?scp=85181202004&partnerID=8YFLogxK
U2 - 10.1177/21925682231223461
DO - 10.1177/21925682231223461
M3 - Article
C2 - 38149647
AN - SCOPUS:85181202004
SN - 2192-5682
JO - Global Spine Journal
JF - Global Spine Journal
ER -