Impact of age on 30-day complications after adult deformity surgery

Kevin Phan; Jun S. Kim; Sulaiman Somani; John Di Capua; Richard Kim; John Shin; Samuel K K Cho

doi:10.1097/BRS.0000000000001832

Impact of age on 30-day complications after adult deformity surgery

Kevin Phan^*, Jun S. Kim, Sulaiman Somani, John Di Capua, Richard Kim, John Shin, Samuel K K Cho

^*Corresponding author for this work

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

27 Citations (Scopus)

Abstract

Study design: Retrospective analysis.

Objective: Identify if age is a risk factor for postoperative complications after Adult Deformity Surgery (ADS).

Summary of background data: Spinal deformity is a prevalent cause of morbidity in the elderly population, occurring in as many as 68% of patients older than 60 years. Given the increasing prevalence of adult spinal deformities and an aging population, understanding the safety of ADS in elderly patients is becoming increasingly important.

Methods: A retrospective cohort analysis was performed on the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database from 2010 to 2014. Patients (≥ 18 years of age) from the NSQIP database undergoing ADS were separated into age-based cohorts (≤52, 53–61, 62–69, and ≥70 years of age). Age groups were determined by interquartile analysis. Chi-squared, t-tests, and multivariate logistic regression models were used to identify independent risk factors.

Results: A total of 5,805 patients met the inclusion criteria. Age groups 1, 2, 3, and 4 contained 1,518 (26.1%), 1,478 (25.4%), 1,451 (25.0%), and 1,358 (23.4%) patients, respectively. Multivariate logistic regression analysis revealed increasing age (relative to age group 1) to be an independent risk factor for prolonged length of stay (OR 1.39, CI 1.12–1.69), all complications (OR 1.64, CI 1.35–2.00), renal complications (OR 3.45, CI 1.43–8.33), urinary tract infection (OR 2.70, CI 1.49–4.76), postoperative transfusion (OR 1.47, CI 1.20–1.82), and unplanned readmission (OR 1.64, CI 1.18–2.23). Gradations in odds ratios existed between the different cohorts, such that the deleterious effect of age was less pronounced in cohort 3 compared to cohort 4, and even more less so between cohort 2 and cohort 4.

Conclusion: Age has been shown to be an independent risk factor for increased length of stay, all complications, renal complications, UTI, transfusion, and unplanned readmission.

Original language	English
Pages (from-to)	120-126
Number of pages	7
Journal	Spine
Volume	43
Issue number	2
DOIs	https://doi.org/10.1097/BRS.0000000000001832
Publication status	Published - 15 Jan 2018
Externally published	Yes

Keywords

adult deformity surgery
age
complications
length of stay
National Surgical Quality Improvement Program
outcomes
readmission
scoliosis
transfusion

Access to Document

10.1097/BRS.0000000000001832

Cite this

@article{77a5c576bfe4419ea3d37c14ebb26409,

title = "Impact of age on 30-day complications after adult deformity surgery",

abstract = "Study design: Retrospective analysis. Objective: Identify if age is a risk factor for postoperative complications after Adult Deformity Surgery (ADS). Summary of background data: Spinal deformity is a prevalent cause of morbidity in the elderly population, occurring in as many as 68% of patients older than 60 years. Given the increasing prevalence of adult spinal deformities and an aging population, understanding the safety of ADS in elderly patients is becoming increasingly important. Methods: A retrospective cohort analysis was performed on the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database from 2010 to 2014. Patients (≥ 18 years of age) from the NSQIP database undergoing ADS were separated into age-based cohorts (≤52, 53–61, 62–69, and ≥70 years of age). Age groups were determined by interquartile analysis. Chi-squared, t-tests, and multivariate logistic regression models were used to identify independent risk factors. Results: A total of 5,805 patients met the inclusion criteria. Age groups 1, 2, 3, and 4 contained 1,518 (26.1%), 1,478 (25.4%), 1,451 (25.0%), and 1,358 (23.4%) patients, respectively. Multivariate logistic regression analysis revealed increasing age (relative to age group 1) to be an independent risk factor for prolonged length of stay (OR 1.39, CI 1.12–1.69), all complications (OR 1.64, CI 1.35–2.00), renal complications (OR 3.45, CI 1.43–8.33), urinary tract infection (OR 2.70, CI 1.49–4.76), postoperative transfusion (OR 1.47, CI 1.20–1.82), and unplanned readmission (OR 1.64, CI 1.18–2.23). Gradations in odds ratios existed between the different cohorts, such that the deleterious effect of age was less pronounced in cohort 3 compared to cohort 4, and even more less so between cohort 2 and cohort 4. Conclusion: Age has been shown to be an independent risk factor for increased length of stay, all complications, renal complications, UTI, transfusion, and unplanned readmission.",

keywords = "adult deformity surgery, age, complications, length of stay, National Surgical Quality Improvement Program, outcomes, readmission, scoliosis, transfusion",

author = "Kevin Phan and Kim, {Jun S.} and Sulaiman Somani and {Di Capua}, John and Richard Kim and John Shin and Cho, {Samuel K K}",

year = "2018",

month = jan,

day = "15",

doi = "10.1097/BRS.0000000000001832",

language = "English",

volume = "43",

pages = "120--126",

journal = "Spine",

issn = "0362-2436",

publisher = "Lippincott Williams & Wilkins",

number = "2",

}

TY - JOUR

T1 - Impact of age on 30-day complications after adult deformity surgery

AU - Phan, Kevin

AU - Kim, Jun S.

AU - Somani, Sulaiman

AU - Di Capua, John

AU - Kim, Richard

AU - Shin, John

AU - Cho, Samuel K K

PY - 2018/1/15

Y1 - 2018/1/15

N2 - Study design: Retrospective analysis. Objective: Identify if age is a risk factor for postoperative complications after Adult Deformity Surgery (ADS). Summary of background data: Spinal deformity is a prevalent cause of morbidity in the elderly population, occurring in as many as 68% of patients older than 60 years. Given the increasing prevalence of adult spinal deformities and an aging population, understanding the safety of ADS in elderly patients is becoming increasingly important. Methods: A retrospective cohort analysis was performed on the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database from 2010 to 2014. Patients (≥ 18 years of age) from the NSQIP database undergoing ADS were separated into age-based cohorts (≤52, 53–61, 62–69, and ≥70 years of age). Age groups were determined by interquartile analysis. Chi-squared, t-tests, and multivariate logistic regression models were used to identify independent risk factors. Results: A total of 5,805 patients met the inclusion criteria. Age groups 1, 2, 3, and 4 contained 1,518 (26.1%), 1,478 (25.4%), 1,451 (25.0%), and 1,358 (23.4%) patients, respectively. Multivariate logistic regression analysis revealed increasing age (relative to age group 1) to be an independent risk factor for prolonged length of stay (OR 1.39, CI 1.12–1.69), all complications (OR 1.64, CI 1.35–2.00), renal complications (OR 3.45, CI 1.43–8.33), urinary tract infection (OR 2.70, CI 1.49–4.76), postoperative transfusion (OR 1.47, CI 1.20–1.82), and unplanned readmission (OR 1.64, CI 1.18–2.23). Gradations in odds ratios existed between the different cohorts, such that the deleterious effect of age was less pronounced in cohort 3 compared to cohort 4, and even more less so between cohort 2 and cohort 4. Conclusion: Age has been shown to be an independent risk factor for increased length of stay, all complications, renal complications, UTI, transfusion, and unplanned readmission.

AB - Study design: Retrospective analysis. Objective: Identify if age is a risk factor for postoperative complications after Adult Deformity Surgery (ADS). Summary of background data: Spinal deformity is a prevalent cause of morbidity in the elderly population, occurring in as many as 68% of patients older than 60 years. Given the increasing prevalence of adult spinal deformities and an aging population, understanding the safety of ADS in elderly patients is becoming increasingly important. Methods: A retrospective cohort analysis was performed on the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database from 2010 to 2014. Patients (≥ 18 years of age) from the NSQIP database undergoing ADS were separated into age-based cohorts (≤52, 53–61, 62–69, and ≥70 years of age). Age groups were determined by interquartile analysis. Chi-squared, t-tests, and multivariate logistic regression models were used to identify independent risk factors. Results: A total of 5,805 patients met the inclusion criteria. Age groups 1, 2, 3, and 4 contained 1,518 (26.1%), 1,478 (25.4%), 1,451 (25.0%), and 1,358 (23.4%) patients, respectively. Multivariate logistic regression analysis revealed increasing age (relative to age group 1) to be an independent risk factor for prolonged length of stay (OR 1.39, CI 1.12–1.69), all complications (OR 1.64, CI 1.35–2.00), renal complications (OR 3.45, CI 1.43–8.33), urinary tract infection (OR 2.70, CI 1.49–4.76), postoperative transfusion (OR 1.47, CI 1.20–1.82), and unplanned readmission (OR 1.64, CI 1.18–2.23). Gradations in odds ratios existed between the different cohorts, such that the deleterious effect of age was less pronounced in cohort 3 compared to cohort 4, and even more less so between cohort 2 and cohort 4. Conclusion: Age has been shown to be an independent risk factor for increased length of stay, all complications, renal complications, UTI, transfusion, and unplanned readmission.

KW - adult deformity surgery

KW - age

KW - complications

KW - length of stay

KW - National Surgical Quality Improvement Program

KW - outcomes

KW - readmission

KW - scoliosis

KW - transfusion

UR - http://www.scopus.com/inward/record.url?scp=84980349895&partnerID=8YFLogxK

U2 - 10.1097/BRS.0000000000001832

DO - 10.1097/BRS.0000000000001832

M3 - Article

C2 - 27488301

AN - SCOPUS:84980349895

SN - 0362-2436

VL - 43

SP - 120

EP - 126

JO - Spine

JF - Spine

IS - 2

ER -

Impact of age on 30-day complications after adult deformity surgery

Abstract

Keywords

Access to Document

Other files and links

Fingerprint

Cite this