Risk factors of epidural hematoma in patients undergoing spinal surgery: a meta-analysis of 29 cohort studies
International Journal of Surgery (London, England) · 20 authors, 6 centres
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This meta-analysis of 29 cohort studies identified older age, obesity, hypertension, diabetes, revision surgery, and multilevel procedures as risk factors for spinal epidural hematoma after spinal surgery.
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A random-effects model was used to calculate pooled odds ratios. High-quality evidence indicated older age (≥60 years) as a risk factor (OR, 1.35; 95% CI, 1.03–1.77). Moderate-quality evidence suggested obesity (BMI ≥25 kg/m²) (OR, 1.39; 95% CI, 1.10–1.76), hypertension (OR, 1.67; 95% CI, 1.28–2.17), diabetes (OR, 1.25; 95% CI, 1.01–1.55), revision surgery (OR, 1.92; 95% CI, 1.15–3.25), and multilevel procedures (OR, 5.20; 95% CI, 2.89–9.37) were associated with higher risk. No association was found for tobacco use, operative time, anticoagulant use, or ASA classification. Limitations include heterogeneity in defining hypertension and SEH, and the observational design precludes inferring causality.
