Elderly age as a risk factor for 30-day postoperative outcomes following elective anterior cervical discectomy and fusion

John Di Capua; Sulaiman Somani; Jun S. Kim; Kevin Phan; Nathan J. Lee; Parth Kothari; Samuel K. Cho

doi:10.1177/2192568217699383

Elderly age as a risk factor for 30-day postoperative outcomes following elective anterior cervical discectomy and fusion

John Di Capua, Sulaiman Somani, Jun S. Kim, Kevin Phan, Nathan J. Lee, Parth Kothari, Samuel K. Cho^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

36 Citations (Scopus)

21 Downloads (Pure)

Abstract

Study Design: Retrospective analysis of prospectively collected data.

Objective: Anterior cervical discectomy and fusion (ACDF) is one of the most commonly performed spinal procedures. Considering the high success and low complications rate of ACDF and high prevalence of age-related degeneration of the cervical spine, the rates of ACDF are expected to continually rise. The objective is to identify the association between patient age and 30-day postoperative outcomes following elective ACDF.

Methods: The 2010-2014 ACS-NSQIP database was queried using Current Procedural Terminology (CPT) codes 22551 or 22554. Patients were divided into age quartiles (18-45, 46-52, 53-60, and ≥61 years). Bivariate and multivariate logistic regression analyses were employed to quantify the increased risk of 30-day postoperative complications in the elderly patient population.

Results: A total of 20 563 patients met the inclusion criteria for the study. The analyses found quartile 4 had an increased odds of length of stay (LOS) ≥5 days (odds ratio [OR] = 2.05, confidence interval [CI ] = 1.62-2.60), pulmonary complications (OR = 3.25, CI = 1.81-5.84), urinary tract infections (UTI) (OR = 2.25, 1.04-4.87, P =.038), cardiac complication (OR = 6.01, CI = 1.36-26.62, P =.018), and sepsis (OR = 4.38, CI = 1.30-14.70, P =.017). Quartiles 2 and 4 had an increased odds of venous thromboembolism (OR = 3.13, CI = 1.14-8.56, P =.026; OR = 3.83, CI = 1.44-10.20, P =.007). Quartiles 3 and 4 experienced an increased odds of unplanned readmission (OR = 1.44, CI = 1.01-2.05, P =.045; OR = 1.88, CI = 1.33-2.66). All P values are <.001 unless otherwise noted.

Conclusion: Elderly patients experienced an increased odds of LOS ≥5 days, pulmonary complications, cardiac compilations, venous thromboembolism, UTI, sepsis, and unplanned readmission. Identification of these factors can improve the selection of appropriate surgical candidates and postoperative safety.

Original language	English
Pages (from-to)	425-431
Number of pages	7
Journal	Global Spine Journal
Volume	7
Issue number	5
DOIs	https://doi.org/10.1177/2192568217699383
Publication status	Published - 1 Aug 2017
Externally published	Yes

Bibliographical note

Copyright the Author(s) 2017. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.

Keywords

ACDF
ACS-NSQIP
anterior
cervical
complications
elderly
fusion
outcomes

Access to Document

10.1177/2192568217699383

Publisher version (open access)Final published version, 200 KBLicence: CC BY-NC-ND

Cite this

@article{d3e3fa87ae0341889447c2486d43446f,

title = "Elderly age as a risk factor for 30-day postoperative outcomes following elective anterior cervical discectomy and fusion",

abstract = "Study Design: Retrospective analysis of prospectively collected data. Objective: Anterior cervical discectomy and fusion (ACDF) is one of the most commonly performed spinal procedures. Considering the high success and low complications rate of ACDF and high prevalence of age-related degeneration of the cervical spine, the rates of ACDF are expected to continually rise. The objective is to identify the association between patient age and 30-day postoperative outcomes following elective ACDF. Methods: The 2010-2014 ACS-NSQIP database was queried using Current Procedural Terminology (CPT) codes 22551 or 22554. Patients were divided into age quartiles (18-45, 46-52, 53-60, and ≥61 years). Bivariate and multivariate logistic regression analyses were employed to quantify the increased risk of 30-day postoperative complications in the elderly patient population. Results: A total of 20 563 patients met the inclusion criteria for the study. The analyses found quartile 4 had an increased odds of length of stay (LOS) ≥5 days (odds ratio [OR] = 2.05, confidence interval [CI ] = 1.62-2.60), pulmonary complications (OR = 3.25, CI = 1.81-5.84), urinary tract infections (UTI) (OR = 2.25, 1.04-4.87, P =.038), cardiac complication (OR = 6.01, CI = 1.36-26.62, P =.018), and sepsis (OR = 4.38, CI = 1.30-14.70, P =.017). Quartiles 2 and 4 had an increased odds of venous thromboembolism (OR = 3.13, CI = 1.14-8.56, P =.026; OR = 3.83, CI = 1.44-10.20, P =.007). Quartiles 3 and 4 experienced an increased odds of unplanned readmission (OR = 1.44, CI = 1.01-2.05, P =.045; OR = 1.88, CI = 1.33-2.66). All P values are <.001 unless otherwise noted. Conclusion: Elderly patients experienced an increased odds of LOS ≥5 days, pulmonary complications, cardiac compilations, venous thromboembolism, UTI, sepsis, and unplanned readmission. Identification of these factors can improve the selection of appropriate surgical candidates and postoperative safety.",

keywords = "ACDF, ACS-NSQIP, anterior, cervical, complications, elderly, fusion, outcomes",

author = "{Di Capua}, John and Sulaiman Somani and Kim, {Jun S.} and Kevin Phan and Lee, {Nathan J.} and Parth Kothari and Cho, {Samuel K.}",

note = "Copyright the Author(s) 2017. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.",

year = "2017",

month = aug,

day = "1",

doi = "10.1177/2192568217699383",

language = "English",

volume = "7",

pages = "425--431",

journal = "Global Spine Journal",

issn = "2192-5682",

publisher = "Georg Thieme Verlag",

number = "5",

}

TY - JOUR

T1 - Elderly age as a risk factor for 30-day postoperative outcomes following elective anterior cervical discectomy and fusion

AU - Di Capua, John

AU - Somani, Sulaiman

AU - Kim, Jun S.

AU - Phan, Kevin

AU - Lee, Nathan J.

AU - Kothari, Parth

AU - Cho, Samuel K.

N1 - Copyright the Author(s) 2017. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.

PY - 2017/8/1

Y1 - 2017/8/1

N2 - Study Design: Retrospective analysis of prospectively collected data. Objective: Anterior cervical discectomy and fusion (ACDF) is one of the most commonly performed spinal procedures. Considering the high success and low complications rate of ACDF and high prevalence of age-related degeneration of the cervical spine, the rates of ACDF are expected to continually rise. The objective is to identify the association between patient age and 30-day postoperative outcomes following elective ACDF. Methods: The 2010-2014 ACS-NSQIP database was queried using Current Procedural Terminology (CPT) codes 22551 or 22554. Patients were divided into age quartiles (18-45, 46-52, 53-60, and ≥61 years). Bivariate and multivariate logistic regression analyses were employed to quantify the increased risk of 30-day postoperative complications in the elderly patient population. Results: A total of 20 563 patients met the inclusion criteria for the study. The analyses found quartile 4 had an increased odds of length of stay (LOS) ≥5 days (odds ratio [OR] = 2.05, confidence interval [CI ] = 1.62-2.60), pulmonary complications (OR = 3.25, CI = 1.81-5.84), urinary tract infections (UTI) (OR = 2.25, 1.04-4.87, P =.038), cardiac complication (OR = 6.01, CI = 1.36-26.62, P =.018), and sepsis (OR = 4.38, CI = 1.30-14.70, P =.017). Quartiles 2 and 4 had an increased odds of venous thromboembolism (OR = 3.13, CI = 1.14-8.56, P =.026; OR = 3.83, CI = 1.44-10.20, P =.007). Quartiles 3 and 4 experienced an increased odds of unplanned readmission (OR = 1.44, CI = 1.01-2.05, P =.045; OR = 1.88, CI = 1.33-2.66). All P values are <.001 unless otherwise noted. Conclusion: Elderly patients experienced an increased odds of LOS ≥5 days, pulmonary complications, cardiac compilations, venous thromboembolism, UTI, sepsis, and unplanned readmission. Identification of these factors can improve the selection of appropriate surgical candidates and postoperative safety.

AB - Study Design: Retrospective analysis of prospectively collected data. Objective: Anterior cervical discectomy and fusion (ACDF) is one of the most commonly performed spinal procedures. Considering the high success and low complications rate of ACDF and high prevalence of age-related degeneration of the cervical spine, the rates of ACDF are expected to continually rise. The objective is to identify the association between patient age and 30-day postoperative outcomes following elective ACDF. Methods: The 2010-2014 ACS-NSQIP database was queried using Current Procedural Terminology (CPT) codes 22551 or 22554. Patients were divided into age quartiles (18-45, 46-52, 53-60, and ≥61 years). Bivariate and multivariate logistic regression analyses were employed to quantify the increased risk of 30-day postoperative complications in the elderly patient population. Results: A total of 20 563 patients met the inclusion criteria for the study. The analyses found quartile 4 had an increased odds of length of stay (LOS) ≥5 days (odds ratio [OR] = 2.05, confidence interval [CI ] = 1.62-2.60), pulmonary complications (OR = 3.25, CI = 1.81-5.84), urinary tract infections (UTI) (OR = 2.25, 1.04-4.87, P =.038), cardiac complication (OR = 6.01, CI = 1.36-26.62, P =.018), and sepsis (OR = 4.38, CI = 1.30-14.70, P =.017). Quartiles 2 and 4 had an increased odds of venous thromboembolism (OR = 3.13, CI = 1.14-8.56, P =.026; OR = 3.83, CI = 1.44-10.20, P =.007). Quartiles 3 and 4 experienced an increased odds of unplanned readmission (OR = 1.44, CI = 1.01-2.05, P =.045; OR = 1.88, CI = 1.33-2.66). All P values are <.001 unless otherwise noted. Conclusion: Elderly patients experienced an increased odds of LOS ≥5 days, pulmonary complications, cardiac compilations, venous thromboembolism, UTI, sepsis, and unplanned readmission. Identification of these factors can improve the selection of appropriate surgical candidates and postoperative safety.

KW - ACDF

KW - ACS-NSQIP

KW - anterior

KW - cervical

KW - complications

KW - elderly

KW - fusion

KW - outcomes

UR - http://www.scopus.com/inward/record.url?scp=85026767647&partnerID=8YFLogxK

U2 - 10.1177/2192568217699383

DO - 10.1177/2192568217699383

M3 - Article

C2 - 28811986

AN - SCOPUS:85026767647

SN - 2192-5682

VL - 7

SP - 425

EP - 431

JO - Global Spine Journal

JF - Global Spine Journal

IS - 5

ER -

Elderly age as a risk factor for 30-day postoperative outcomes following elective anterior cervical discectomy and fusion

Abstract

Bibliographical note

Keywords

Access to Document

Other files and links

Fingerprint

Cite this