P74. Adult spinal deformity patients with metabolic syndrome have significantly higher costs

BACKGROUND CONTEXT Adult spinal deformity (ASD) correction involves complex, invasive procedures. However, it is unknown how metabolic syndrome affects the cost efficiency of ASD surgery. PURPOSE Investigate the differences in ASD surgery cost for metabolic syndrome patients. STUDY DESIGN/SETTING Retrospective review of a single center ASD database. PATIENT SAMPLE A total of 557 ASD patients. OUTCOME MEASURES Complications, revisions and costs. METHODS ASD patients (scoliosis ≥20°, SVA≥5cm, PT ≥25°, or TK ≥60°) ≥18, undergoing ≥4 level fusions were included. Descriptive analysis assessed mean baseline demographic, radiographic and surgical data were assessed. Patients diagnosed with: BMI \u003e30, diabetes mellitus, and HTN were classified metabolic syndrome patients (MetS). Independent samples T-tests assessed baseline differences in SVA, PT, PI-LL, and levels fused between MetS and non-MetS patients. Total surgery costs for MetS and non-MetS ASD patients were compared. Costs were calculated using the PearlDiver database, which reflects both private insurance and Medicare reimbursement claims. Complications and comorbidities (CC) and major complications and comorbidities (MCC) were assessed according to CMS.gov manual definitions. RESULTS A total of 557 patients met inclusion criteria. Baseline demographics and surgical details: age 60.8 ± 13.2, 67.5% female, BMI 28.3 ± 6.67, 6.2% anterior approach, 81.0% posterior approach, 12.8% combined approach, 10.4 ± 3.9 levels fused, op time 423.5 ± 166.4 minutes, EBL 2061.4 ± 1631.5 cc, LOS 7.6 ± 5.4 days. 11 MetS patients were included. There was no significant difference in BL SVA (54.2° vs 70.3°), PT (26.7° vs 23.7°), PI-LL (16.4° vs 21.2°), or levels fused between groups (10.5 vs 10.6) (all p\u003e0.05). Twenty-seven percent of MetS patients experienced a CC or MCC, with 18% undergoing revisions within 90 days (vs 13.2% and 3.2% for non-MetS, p CONCLUSIONS Metabolic syndrome is a growing concern among health care providers. In metabolic syndrome patients undergoing corrective adult spinal deformity surgery, the total costs of surgery was 28.4% higher for metabolic syndrome patients ($68,004.06 vs $48,726.40). Optimizing modifiable factors like diabetes or BMI in preoperative patients may have an impact on cost effectiveness. FDA DEVICE/DRUG STATUS This abstract does not discuss or include any applicable devices or drugs.