LAUSR

BACKGROUND Preoperative laboratory tests are varied in their administration among physicians, and previous studies have published conflicting reports on their utility. Anterior cervical discectomy and fusion (ACDF) is a commonly performed spine surgery, and patients often undergo preoperative testing. OBJECTIVE To assess the relationship between preoperative laboratory values and risk for adverse postoperative outcomes following ACDF. METHODS ACS-NSQIP was queried from 2012-2017 to identify patients undergoing elective ACDF. Multivariable logistic regression was performed to assess the association between abnormal laboratory test values and adverse 30-day outcomes. Relative predictor importance was determined using an importance metric defined as Wald χ2 penalized by degrees of freedom. RESULTS A total of 47,111 patients were included. On multivariable analysis, high creatinine (p=0.030), anemia (p<0.001), hyponatremia (p=0.034), and leukocytosis (p<0.001) were found to be significantly associated with any 30-day complications. Anemia (p<0.001), hypernatremia (p=0.028), hyponatremia (p=0.016), and leukocytosis (p<0.001) were found to be significantly associated with serious 30-day complications. High creatinine (p=0.027), anemia (p<0.001), hyponatremia (p=0.047), and leukocytosis (p=0.004) were found to be significantly associated with 30-day unplanned readmissions. High blood urea nitrogen (p=0.007), high creatinine (p=0.028), anemia (p<0.001), low platelet count (p<0.001), hyponatremia (p<0.001), and leukocytosis (p<0.001) were found to be significantly associated with non-home discharge. Predictor importance analysis revealed that abnormal preoperative lab values were important determinants in predicting these 30-day outcomes. CONCLUSION Our analyses indicate that abnormal preoperative lab values are associated with increased risk for adverse outcomes following elective ACDF and can be used in predictive analyses of outcomes.