Postoperative Complications Following Orthopedic Spine Surgery: Is There a Difference Between Men and Women?

Background: Patient sex is known to affect outcomes following surgery. Prior studies have not specifically examined sex-stratified outcomes following spine surgery. The objective is to determine the differences between men and women in terms of 30-day complications following spine surgery. Methods: The National Surgical Quality Improvement Program database was queried for patients undergoing spine surgery from 2005 to 2014. Postoperative data were analyzed to determine the differences between men and women with regard to 30-day complications. Results: A total of 41 315 patients (49.0% women, 51% men) were analyzed. Men were more likely to have diabetes (P = .004) and be active smokers (P < .001). Women were more likely to be taking steroids for chronic conditions (P < .001). Postoperatively, women were at increased risk for superficial surgical site infection, urinary tract infection, transfusions, and longer length of stay, whereas men were at increased risk of pneumonia and reintubation. On multivariate analysis, women were associated with urinary tract infections (odds ratio = 2.17) and transfusions (odds ratio = 1.63). Conclusions: Differences in complications are evident between men and women following spine surgery. These differences should be considered during preoperative planning and when consenting patients for surgery.