Complications and Readmission After Cervical Spine Surgery in Elderly Patients: An Analysis of 1,786 Patients.

Complications and Readmission After Cervical Spine Surgery in Elderly Patients: An Analysis of 1,786 Patients.

World Neurosurg. 2017 Apr 26;:

Authors: Bernstein DN, Thirukumaran C, Saleh A, Molinari RW, Mesfin A

Abstract
OBJECTIVE: To investigate risk factors and complications from cervical spine surgery in elderly patients METHODS: A retrospective study was performed using data from the American College of Surgeons - National Surgical Quality Improvement Program (ACS NSQIP). Patients aged 65 and older who underwent cervical spine surgery from 2005-2013 were identified using ICD-9-CM diagnosis and CPT codes. Outcome data was classified as: major complication, minor complication, readmission, or mortality.
RESULTS: 1,786 patients 65 and older undergoing cervical spine surgery were identified. 175 (9.80%) patients experienced at least one complication or death. Patients aged 75 and older were at higher risk of developing a complication or death (OR: 1.72 [1.13-2.61]. Increased operative times (OR: 3.54 [2.27-5.53], patients who were partially or total dependent (OR: 3.01 [1.79-5.07]) and patients listed as an ASA Class > 2 (OR: 1.87 [1.20-2.94]) were associated with perioperative complications. Patients between the age of 70-74 (OR: 1.94 [1.03-3.65]) and those with at least one postoperative complication (OR: 9.59 [5.17-17.80]) had increased risks of unplanned readmissions. Patients aged 75 and older undergoing a laminectomy/laminotomy were at higher risk of complication (OR: 3.20 [1.33-7.70]), while there was no difference in risk of complication based on age for elderly patients undergoing a fusion.
CONCLUSIONS: Patient comorbidities and clinical factors, such as longer operating time and emergency cases, impact risk of adverse events. Patients between the age of 70-74 and those with at least one postoperative complication had an increased risk of unplanned readmission.

PMID: 28456739 [PubMed - as supplied by publisher]

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