年龄是硬脊膜内髓外脊髓肿瘤切除术后椎板切除术并发症的一个危险因素。
Age Is a Risk Factor for Postoperative Complications Following Excisional Laminectomy for Intradural Extramedullary Spinal Tumors.
作者信息
Phan Kevin, Vig Khushdeep S, Ho Yam Ting, Hussain Awais K, Di Capua John, Kim Jun S, White Samuel J W, Lee Nathan J, Kothari Parth, Cho Samuel K
机构信息
Prince of Wales Private Hospital, Sydney, New South Wales, Australia.
University of New South Wales, Sydney, New South Wales, Australia.
出版信息
Global Spine J. 2019 Apr;9(2):126-132. doi: 10.1177/2192568218754512. Epub 2018 Aug 13.
STUDY DESIGN
Retrospective analysis.
OBJECTIVE
The incidence of intradural extramedullary (IDEM) spinal tumors is increasing. Excisional laminectomy for removal and decompression is the standard of care, but complications associated with patient age are unreported in the literature. Our objective is to identify if age is a risk factor for postoperative complications after excisional laminectomy of IDEM spinal tumors.
METHODS
A retrospective analysis was performed on the 2011 to 2014 ACS-NSQIP (American College of Surgeons National Surgical Quality Improvement Program) database for patients undergoing excisional laminectomy of IDEM spinal tumors. Age groups were determined by interquartile analysis. Chi-squared tests, tests, and multivariate logistic regression models were employed to identify independent risk factors. Institutional review board approval was not needed.
RESULTS
A total of 1368 patients met the inclusion criteria for the study. Group 1 (age ≤ 44) contained 372 patients, group 2 (age 45-54) contained 314 patients, group 3 (age 55-66) contained 364 patients, and group 4 (age > 66) contained 318 patients. The univariate analysis showed that mortality and unplanned readmission were highest among patients in group 4 (1.26%, = .011, and 10.00%, = .039, respectively). Postoperative wound complications were highest among patients in group 1 (2.15%, = .009), and postoperative venous thromboembolism and cardiac complications were highest among patients in group 3 (4.4%, = .007, and 1.10%, = .032, respectively). Multivariate logistic regression revealed that elderly age was an independent risk factor for postoperative venous thromboembolism (group 3 vs group 1; odds ratio = 6.739, confidence interval = 1.522-29.831, = .012).
CONCLUSIONS
This analysis revealed that increased age is an independent risk factor for postoperative venous thromboembolism in patients undergoing excisional laminectomy for IDEM spinal tumors.
研究设计
回顾性分析。
目的
硬脊膜内髓外（IDEM）脊髓肿瘤的发病率正在上升。切除性椎板切除术用于肿瘤切除及减压是标准治疗方法，但文献中未报道与患者年龄相关的并发症。我们的目的是确定年龄是否为IDEM脊髓肿瘤切除性椎板切除术后发生术后并发症的危险因素。
方法
对2011年至2014年美国外科医师学会国家外科质量改进计划（ACS-NSQIP）数据库中接受IDEM脊髓肿瘤切除性椎板切除术的患者进行回顾性分析。年龄组通过四分位数分析确定。采用卡方检验、t检验和多因素逻辑回归模型来确定独立危险因素。无需机构审查委员会批准。
结果
共有1368例患者符合该研究的纳入标准。第1组（年龄≤44岁）有372例患者，第2组（年龄45 - 54岁）有314例患者，第3组（年龄55 - 66岁）有364例患者，第4组（年龄>66岁）有318例患者。单因素分析显示，第4组患者的死亡率和非计划再入院率最高（分别为1.26%，P = 0.011；10.00%，P = 0.039）。术后伤口并发症在第1组患者中最高（2.15%，P = 0.009），术后静脉血栓栓塞和心脏并发症在第3组患者中最高（分别为4.4%，P = 0.007；1.10%，P = 0.032）。多因素逻辑回归显示，高龄是术后静脉血栓栓塞的独立危险因素（第3组与第1组相比；比值比 = 6.739，置信区间 = 1.522 - 29.831，P = 0.012）。
结论
该分析表明，年龄增加是接受IDEM脊髓肿瘤切除性椎板切除术患者术后静脉血栓栓塞的独立危险因素。
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