Perioperative medicine & outcomes
Hypothyroidism as a risk factor for perioperative complications in lumbar spine surgery: a national database study
Authors' conclusion
This study suggests a correlation between hypothyroidism and a higher risk of complications in patients undergoing lumbar spine surgery.
Study context
- Population
- Patients undergoing lumbar spine surgery (LSS), Nationwide Inpatient Sample 2013–202211.66% hypothyroid
- Participants
- 873,110 patients
- Exposure
- Hypothyroidism vs no hypothyroidism
- Outcome
- Perioperative complications
Methodological detailspropensity-score matched (1:1), national database (Nationwide Inpatient Sample (NIS) 2013-2022), multivariable logistic regression
- Propensity-score matched (1:1)
- National database (NIS 2013-2022)
- Multivariable logistic regression
Main finding
As reported in the abstract
Perioperative complications, overall LSS cohort
- Hypothyroidism associated with significantly increased odds ratios (ORs) for sepsis, postoperative shock, postoperative delirium, acute cerebrovascular disease, acute MI, congestive HF, DVT, pneumonia, PE, respiratory failure, urinary tract infection, transfusion, wound infection, wound dehiscence, in-hospital mortality and prolonged length of stay (LOS)
- P < 0.001 for all
Observational data: associations, not effects.
Further findings
Age
P < 0.001
Complications, lumbar fusion alone (subgroup)
- Significantly elevated ORs for all complications
Complications, lumbar decompression alone or discectomy alone (subgroups)
- Increases in ORs for wound infection and wound dehiscence not statistically significant
- Discectomy alone: elevated ORs for postoperative shock and acute MI not statistically significant
- All other complications: statistically significant elevated ORs
Original publication
Hypothyroidism as a risk factor for perioperative complications in lumbar spine surgery: a national database study. Perioper Med (Lond). Published 9 December 2025. doi:10.
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