PT - JOURNAL ARTICLE AU - Ghali, Abdullah AU - Prabhakar, Gautham AU - Momtaz, David AU - Ahmad, Farhan AU - Abbas, Adam AU - Shamim, Muhammad AU - Issa, Mahmoud AU - Bora, Varun AU - Chaput, Christopher TI - Preoperative Dehydration Predicts Adverse Events Following Anterior Cervical Discectomy and Fusion AID - 10.14444/8544 DP - 2023 Dec 01 TA - International Journal of Spine Surgery PG - 835--842 VI - 17 IP - 6 4099 - https://www.ijssurgery.com/content/17/6/835.short 4100 - https://www.ijssurgery.com/content/17/6/835.full SO - Int J Spine Surg2023 Dec 01; 17 AB - Background Anterior cervical discectomy and fusion (ACDF) is a common procedure for neck arthritis, typically alleviating pain and improving function. Preoperative dehydration has been correlated with postoperative infection, acute renal failure, deep vein thrombosis, and increased hospital length of stay. However, some studies have suggested that preoperative dehydration has a minimal relationship with postoperative outcomes, specifically in arthroplasty and lumbar surgery candidates.Methods Patients who underwent ACDF from 2015 to 2020 as part of the American College of Surgeons National Surgical Quality Improvement Program database were identified. We excluded patients who presented with acute trauma. Dehydration was determined using the accepted definition of preoperative blood urea nitrogen to creatinine ratio greater than 20. Lengths of stay and 30-day postoperative adverse events were compared between dehydrated and nondehydrated cohorts, adjusting for baseline features using standard multivariate regression.Results We identified 14,932 patients, and 4206 (28.1%) of whom were preoperatively dehydrated. Dehydrated patients had significantly higher odds of wound, hematological, and pulmonary complications; Clavien-Dindo grade IV, delayed length of stay (>5 days); and a lower likelihood of being discharged home (P < 0.005), even after controlling for demographic features (eg, sex, age, body mass index, race, and ethnicity). Furthermore, linear regression suggested an overall half-day increased length of hospital stay for dehydrated patients (95% CI [0.36, 0.60], P < 0.001).Conclusion Preoperative dehydration is common among ACDF surgery patients and appears to correlate with an increased risk of postoperative complications and prolonged length of hospital stay. Evaluation of a patient’s hydration status from standard preoperative laboratory metrics can be employed for risk stratification, patient counseling, and timing of ACDF surgeries.Level of Evidence 3.