Lagman Carlito, Ugiliweneza Beatrice, Boakye Maxwell, Drazin Doniel
Department of Neurosurgery, Cedars-Sinai Medical Center, Los Angeles, California, USA.
Department of Neurosurgery, University of Louisville, Louisville, Kentucky, USA.
World Neurosurg. 2017 Jul;103:780-788. doi: 10.1016/j.wneu.2017.04.001. Epub 2017 Apr 11.
To compare spine surgery outcomes in elderly patients (80-103 years old) versus general adult patients (18-79 years-old) in the United States.
Truven Health Analytics MarketScan Research Databases (2000-2012) were queried. Patients with a diagnosis of degenerative disease of the spine without concurrent spinal stenosis, spinal stenosis without concurrent degenerative disease, or degenerative disease with concurrent spinal stenosis and who had undergone decompression without fusion, fusion without decompression, or decompression with fusion procedures were included. Indirect outcome measures included length of stay, in-hospital mortality, in-hospital and 30-day complications, and discharge disposition.
Patients (N = 155,720) were divided into elderly (n = 10,232; 6.57%) and general adult (n = 145,488; 93.4%) populations. Mean length of stay was longer in elderly patients versus general adult patients (3.62 days vs. 3.11 days; P < 0.0001). In-hospital mortality was more common in elderly patients versus general adult patients (0.31% vs. 0.06%; P < 0.0001). In-hospital and 30-day complications were more common in elderly patients versus general adult patients (11.3% vs. 7.15% and 17.8% vs. 12.6%; P < 0.0001). Nonroutine discharge was more common in elderly patients versus general adult patients (33.7% vs. 16.2%; P < 0.0001).
Our results revealed significantly longer hospital stays, more in-hospital mortalities, and more in-hospital and 30-day complications after decompression without fusion, fusion without decompression, or decompression with fusion procedures in elderly patients.
比较美国老年患者（80 - 103岁）与普通成年患者（18 - 79岁）脊柱手术的结果。
查询了Truven Health Analytics MarketScan研究数据库（2000 - 2012年）。纳入诊断为脊柱退行性疾病且无并发椎管狭窄、椎管狭窄且无并发退行性疾病、或退行性疾病并发椎管狭窄，并且接受了减压不融合、融合不解压或减压融合手术的患者。间接结局指标包括住院时间、住院死亡率、住院期间及30天并发症以及出院去向。
患者（N = 155,720）分为老年组（n = 10,232；6.57%）和普通成年组（n = 145,488；93.4%）。老年患者的平均住院时间比普通成年患者更长（3.62天对3.11天；P < 0.0001）。老年患者的住院死亡率比普通成年患者更常见（0.31%对0.06%；P < 0.0001）。老年患者的住院期间及30天并发症比普通成年患者更常见（11.3%对7.15%以及17.8%对12.6%；P < 0.0001）。老年患者非常规出院比普通成年患者更常见（33.7%对16.2%；P < 0.0001）。
我们的结果显示，老年患者在接受减压不融合、融合不解压或减压融合手术后，住院时间显著更长，住院死亡率更高，住院期间及30天并发症更多。
