131 - High Serum Alkaline Phosphatase is Associated with Increased Perioperative Complications after Lumbar Spinal Fusion

Saturday, June 3, 2023

11:40 AM – 11:42 AM

Location: Salons 13-15

Presenting Author (Person doing the Podium Present(s)

JC

Justin P. Chan, MD

Resident Physician
University of California, Irvine
Irvine, California, United States

Co-Author(s)

BL

Brandon Lung

United States
JO

Jonathan Ochoa

United States
JC

Jeffrey Choi

United States
SH

Sohaib Hashmi

United States
NB

Nitin Bhatia

United States
YL

Yu-Po Lee

United States

Submitter(s)

JC

Justin P. Chan, MD

Resident Physician
University of California, Irvine
Irvine, California, United States

Introduction:
Alkaline phosphatase (ALP) is an enzyme which has been proven useful as a biomarker for bone turnover and inflammation. We hypothesized that high serum ALP levels are associated with increased complication rates following lumbar spinal fusion.

Aims/

Objectives:
Our objective is to determine the correlation between abnormal serum ALP levels and postoperative outcomes to inform clinical care and decision making.

Methods:
Lumbar spinal fusion procedures from 2005-2019 were queried from the national Surgical Quality Improvement Program (NSQIP) database. Serum alkaline phosphatase levels were stratified into low < 44 IU/L, normal 44-147 IU/L, and high >147 IU/L. A risk-adjusted multivariate logistic regression was used to analyze ALP as an independent risk factor for complications.

Results:
A total of 16,441 patients who underwent lumbar fusion procedures were included. Adjusted multivariate logistic regression analysis demonstrated that patients with a high serum ALP level had a significantly increased risk for developing septic shock (OR 4.66), pneumonia (OR 2.89), requiring a transfusion (OR 2.09), reoperation within 30 days (OR 1.68), readmission within 30 days (OR 1.60), increased length of stay (OR 1.87), and nonhome discharge (OR 2.18)

Conclusions:
Elevated serum ALP in patients undergoing lumbar fusion procedures is associated with increased risk for multiple in-hospital complications as well as higher rates of readmission and reoperation.