Bronheim RS, et al. - The ability of abnormal coagulation profile to predict adverse events following posterior cervical laminectomy and fusion (PCLF) was assessed herein. Findings demonstrated that abnormal coagulation profile independently predicted outcomes following PCLF and moreover, it enabled prediction of complications that can be medically mitigated and is hence a valuable parameter to assess preoperatively. In targeting patients for risk stratification, preoperative optimization, and quality improvement initiatives, coagulation profile should continue to play a role.

• Researches utilized ACS-NSQIP to identify patients undergoing PCLF between 2006 and 2013.
• A total of 3546 patients met inclusion criteria.
• They also used multivariate analysis to identify links between abnormal coagulation profile and postoperative complications.

• Findings demonstrated that membership in the low-platelet cohort was an independent risk factor for myocardial infarction (Odds Ratio (OR) = 5.4 [1.0, 29.1], P=0.049) and bleeding transfusion (OR = 2.0 [1.2, 3.4], P=0.011).
• Researchers identified that membership in the high international normalized ratio group was an independent risk factor for the following: pneumonia (OR = 6.3 [2.5, 16.1], P < 0.001), ventilation >48 hours (OR = 6.5 [2.3, 18.4], P < 0.001), organ space surgical site infection (OR = 11.1 [2.1, 57.3], P=0.004), urinary tract infection (OR = 3.0 [1.2, 8.0], P=0.024), bleeding transfusion (OR = 6.0 [3.4, 10.7], P < 0.001), sepsis (OR = 5.1 [1.6, 16.4], P=0.006), and septic shock (OR = 6.8 [1.7, 27.4], P=0.007).
• In addition, they noted that membership in the bleeding disorders cohort was independently predicted the following: unplanned intubation (OR = 3.2 [1.1, 9.5], P=0.041), pneumonia (OR = 2.9 [1.2, 7.2], P=0.023), ventilation >48 hours (OR = 4.8 [1.9, 12.4], P=0.001), cerebrovascular accident/stroke with neurological deficit (OR = 24.8 [2.9, 210.6], P=0.003), bleeding transfusion (OR = 2.1 [1.1, 4.1], P=0.032), reoperation (OR = 3.6 [1.4, 9.3], P=0.008), and sepsis (OR = 3.4 [1.1, 10.4], P=0.031).