Frequency and Risk Factors of Abdominal Complications After Iliac Crest Harvest Procedures.

BACKGROUND

Although abdominal complications (ACs) have been described after iliac crest harvest procedures (IP), their frequency, risk factors, and clinical and economic impact remain unclear.

PURPOSE: The purpose of this study was to estimate the frequency of ACs after IP, and to identify risk factors of ACs, in-hospital mortality, hospital length of stay (LOS), and charges in the United States.

STUDY DESIGN, SETTING, SAMPLE: A retrospective cohort study was designed using the 2020-2022 National Inpatient Sample database from which IP was queried. Discharge weights were applied to estimate nationally representative weighted frequencies and means of the study variables.

PREDICTOR VARIABLE: The predictor variables included socio-demographic, clinical, and hospital-level characteristics.

MAIN OUTCOME VARIABLES: The primary outcome variable was occurrence of ACs. Secondary outcome variables included in-hospital mortality, LOS, hospital charges, and postadmission disposition.

COVARIATES: There were no covariates.

ANALYSES: Descriptive statistics were calculated to obtain weighted frequencies and means, and multivariable logistic and linear regression models were obtained to identify risk factors of ACs, in-hospital mortality, LOS, and charges. Level of statistical significance was P < .05.

RESULTS

Of 151,665 weighted hospitalizations involving IP (mean age 58.4 years, 49.8% female), there were 890 ACs (0.6%), which included iatrogenic organ injury, hematoma, hemorrhage, and partial bowel obstruction. Peripheral vascular disease and female sex were risk factors of complications (adjusted odds ratio, 1.89 and 0.58; 95% CI, 1.03-3.31 and 0.42-0.79, P ≤ .04). ACs were a risk factor of mortality (adjusted odds ratio 5.67; 95% CI, 1.84-17.43, P < .001), LOS (P < .001), and charges (P < .001), and open surgical approach was associated with higher in-hospital mortality (OR, 1.51; 95% CI, 1.02-2.24, P = .04) and LOS (P < .001), but lower charges (P < .001).

CONCLUSIONS AND RELEVANCE: Although rare, ACs after IP have an adverse impact on mortality and resource utilization. Knowledge of their risk factors can guide clinicians and institutions to improving outcomes and efficiency of care delivery.