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Purpose <p> <!--Query ID="Q1" Text="Please check and confirm that the identified article title is correct." Resolved="yes"-->This study aimed to elucidate the association between comorbid hypertension (HT) and diabetes mellitus (DM) (HT in DM) and clinical outcomes after cervical laminoplasty.</p> Methods <p>This retrospective multi-institutional study enrolled patients who underwent laminoplasty between 2008 and 2017. The primary outcome was the recovery rate of JOA score. The secondary outcome was in-hospital all-cause postoperative complications.</p> Results <p>This study included 1002 patients (mean age, 66 years; 30% women) who were divided into 4 groups based on the presence of medically-treated HT and/or DM. The overall incidence of DM was 17%, and the prevalence of HT was 47% in diabetic patients. Patients with HT in DM showed similar preoperative JOA scores compared to those without both HT and DM. However, patients with HT in DM showed poorer postoperative JOA scores and worse JOA-RR (non-HT/DM, 48%; DM, 43%; HT, 37%; HT in DM, 28%; <i>p</i> &lt; 0.05). Patients with HT in DM tended to have a higher risk of postoperative complications (2.5%, 5.4%, 3.0%, and 7.4%; <i>p</i> = 0.09), especially C5 palsy (0.8%, 3.0%, 1.7%, and 4.9%; <i>p</i> = 0.04). After adjusting confounders, the presence of HT in DM was an independent risk factor for failure to achieve the JOA-RR MCID (JOA-RR &lt; 42%) (OR = 3.6).</p> Conclusions <p>Approximately half of patients with DM had HT. HT in DM was closely associated with unfavorable surgical outcomes, including an increased incidence of in-hospital postoperative complications and an elevated risk of C5 palsy. In contrast, patients with DM alone demonstrated relatively favorable outcomes.</p>

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Impact of hypertension in diabetes on surgical outcomes after cervical laminoplasty - a retrospective, multi-institutional study of 1002 patients

  • 期刊论文

  • 发表日期：

    2025年2月6日

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  • Yusuke Tomomatsu,
  • Eiji Takasawa,
  • Yoichi Iizuka,
  • Tokue Mieda,
  • Hirokazu Inoue,
  • Atsushi Kimura,
  • Katsushi Takeshita,
  • Hiroyuki Sonoda,
  • Kenta Takakura,
  • Yasunori Sorimachi,
  • Tsuyoshi Ara,
  • Kosuke Shida,
  • Takashi Nakajima,
  • Satoshi Tsutsumi,
  • Hidekazu Arai,
  • Hiroshi Moridaira,
  • Hiroshi Taneichi,
  • Toru Funayama,
  • Hiroshi Noguchi,
  • Kousei Miura,
  • Ryoichi Kobayashi,
  • Haku Iizuka,
  • Masaaki Chazono,
  • Hirotaka Chikuda

摘要

Purpose

This study aimed to elucidate the association between comorbid hypertension (HT) and diabetes mellitus (DM) (HT in DM) and clinical outcomes after cervical laminoplasty.

Methods

This retrospective multi-institutional study enrolled patients who underwent laminoplasty between 2008 and 2017. The primary outcome was the recovery rate of JOA score. The secondary outcome was in-hospital all-cause postoperative complications.

Results

This study included 1002 patients (mean age, 66 years; 30% women) who were divided into 4 groups based on the presence of medically-treated HT and/or DM. The overall incidence of DM was 17%, and the prevalence of HT was 47% in diabetic patients. Patients with HT in DM showed similar preoperative JOA scores compared to those without both HT and DM. However, patients with HT in DM showed poorer postoperative JOA scores and worse JOA-RR (non-HT/DM, 48%; DM, 43%; HT, 37%; HT in DM, 28%; p < 0.05). Patients with HT in DM tended to have a higher risk of postoperative complications (2.5%, 5.4%, 3.0%, and 7.4%; p = 0.09), especially C5 palsy (0.8%, 3.0%, 1.7%, and 4.9%; p = 0.04). After adjusting confounders, the presence of HT in DM was an independent risk factor for failure to achieve the JOA-RR MCID (JOA-RR < 42%) (OR = 3.6).

Conclusions

Approximately half of patients with DM had HT. HT in DM was closely associated with unfavorable surgical outcomes, including an increased incidence of in-hospital postoperative complications and an elevated risk of C5 palsy. In contrast, patients with DM alone demonstrated relatively favorable outcomes.