De la Garza Ramos Rafael, Goodwin C Rory, Jain Amit, Martinez-Ramirez Daniel, Karikari Isaac O, Sciubba Daniel M
Department of Neurological Surgery, Montefiore Medical Center/Albert Einstein College of Medicine, New York, USA.
Department of Orthopaedic Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
J Spine Surg. 2017 Dec;3(4):601-608. doi: 10.21037/jss.2017.11.09.
To investigate the inpatient perioperative morbidity rate of patients with movement disorders (MD) after spinal deformity surgery.
The Nationwide Inpatient Sample database from 2002 to 2011 was queried to identify adult patients with MD who underwent spinal deformity surgery. Complication rates were compared between patients with MD and controls. A multiple logistic regression analysis was conducted to assess the effect of MD on outcome.
A total of 365 patients with MD (3.3%) were identified among 11,043 patients undergoing surgery for spinal deformity. Patients with MD were on average 8 years older than the control group (67 59 years of age, P<0.001). The complication rate was 55.1% for patients with MD and 43.7% for patients without MD (P<0.001). The most common complication was acute post-hemorrhagic anemia, which occurred in 31.9% of all patients (41.6% in MD patients and 31.5% in the control group, P<0.001). Other complications that were more common in patients with MD included delirium (P<0.001), acute kidney injury (P=0.032), and pulmonary embolism (P=0.014). After controlling for patient age, sex, osteoporosis, complex procedures, fusion to the lumbosacral spine, use of bone morphogenetic protein, and use of blood transfusion, patients with MD were 1.3 times more likely to develop a complication compared to patients without MD [odds ratio (OR), 1.27; 95% confidence interval (CI), 1.02-1.59; P=0.032] on multiple logistic regression analysis. No significant difference in hospital stay was observed.
Patients with MD who undergo spinal deformity surgery may be at risk of higher rate of complications compared to patients without these disorders.
调查脊柱畸形手术后运动障碍（MD）患者的住院围手术期发病率。
查询2002年至2011年的全国住院患者样本数据库，以确定接受脊柱畸形手术的成年MD患者。比较MD患者与对照组的并发症发生率。进行多因素逻辑回归分析以评估MD对结局的影响。
在11043例接受脊柱畸形手术的患者中，共识别出365例MD患者（3.3%）。MD患者的平均年龄比对照组大8岁（67岁对59岁，P<0.001）。MD患者的并发症发生率为55.1%，无MD患者为43.7%（P<0.001）。最常见的并发症是急性出血后贫血，在所有患者中发生率为31.9%（MD患者中为41.6%，对照组中为31.5%，P<0.001）。在MD患者中更常见的其他并发症包括谵妄（P<0.001）、急性肾损伤（P=0.032）和肺栓塞（P=0.014）。在控制患者年龄、性别、骨质疏松症、复杂手术、腰骶椎融合、骨形态发生蛋白的使用和输血的使用后，多因素逻辑回归分析显示，与无MD患者相比，MD患者发生并发症的可能性高1.3倍[比值比（OR），1.27；95%置信区间（CI），1.02-1.59；P=；0.032]。住院时间未观察到显著差异。
与无这些疾病的患者相比，接受脊柱畸形手术的MD患者可能有更高的并发症发生率风险。
