Incidence of perioperative medical complications and mortality among elderly patients undergoing surgery for spinal deformity: analysis of 3519 patients.

Jain, Amit

Hassanzadeh, Hamid

Puvanesarajah, Varun

Klineberg, Eric O

Sciubba, Daniel M

Kelly, Michael P

Hamilton, D Kojo

Lafage, Virginie

Buckland, Aaron J

Passias, Peter G

Protopsaltis, Themistocles S

Lafage, Renaud

Smith, Justin S

Shaffrey, Christopher I

Kebaish, Khaled M

International Spine Study Group

2023-07-08T13:53:15Z

2023-07-08T13:53:15Z

2017-11

2023-07-08T13:53:15Z

OBJECTIVE Using 2 complication-reporting methods, the authors investigated the incidence of major medical complications and mortality in elderly patients after surgery for adult spinal deformity (ASD) during a 2-year follow-up period. METHODS The authors queried a multicenter, prospective, surgeon-maintained database (SMD) to identify patients 65 years or older who underwent surgical correction of ASD from 2008 through 2014 and had a minimum 2 years of follow-up (n = 153). They also queried a Centers for Medicare & Medicaid Services claims database (MCD) for patients 65 years or older who underwent fusion of 8 or more vertebral levels from 2005 through 2012 (n = 3366). They calculated cumulative rates of the following complications during the first 6 weeks after surgery: cerebrovascular accident, congestive heart failure, deep venous thrombosis, myocardial infarction, pneumonia, and pulmonary embolism. Significance was set at p < 0.05. RESULTS During the perioperative period, rates of major medical complications were 5.9% for pneumonia, 4.1% for deep venous thrombosis, 3.2% for pulmonary embolism, 2.1% for cerebrovascular accident, 1.8% for myocardial infarction, and 1.0% for congestive heart failure. Mortality rates were 0.9% at 6 weeks and 1.8% at 2 years. When comparing the SMD with the MCD, there were no significant differences in the perioperative rates of major medical complications except pneumonia. Furthermore, there were no significant intergroup differences in the mortality rates at 6 weeks or 2 years. The SMD provided greater detail with respect to deformity characteristics and surgical variables than the MCD. CONCLUSIONS The incidence of most major medical complications in the elderly after surgery for ASD was similar between the SMD and the MCD and ranged from 1% for congestive heart failure to 5.9% for pneumonia. These complications data can be valuable for preoperative patient counseling and informed consent.

1547-5654

1547-5646

https://hdl.handle.net/10161/28363

eng

Journal of Neurosurgery Publishing Group (JNSPG)

Journal of neurosurgery. Spine

10.3171/2017.3.spine161011

International Spine Study Group

Humans

Spinal Curvatures

Postoperative Complications

Spinal Fusion

Incidence

Follow-Up Studies

Prospective Studies

Databases, Factual

Aged

Medicare

United States

Female

Male

Perioperative Period

Surgeons

Incidence of perioperative medical complications and mortality among elderly patients undergoing surgery for spinal deformity: analysis of 3519 patients.

Journal article

Passias, Peter G|0000-0002-1479-4070|0000-0003-2635-2226

Shaffrey, Christopher I|0000-0001-9760-8386

534

539

5

Duke

School of Medicine

Clinical Science Departments

Orthopaedic Surgery

Neurosurgery

Published

27