Gupta Anmol, Cha Thomas, Schwab Joseph, Fogel Harold, Tobert Daniel, Qureshi Sheeraz, Hecht Andrew, Bono Christopher M, Hershman Stuart
yIcahn School of Medicine at Mount Sinai, The Mount Sinai Hospital, New York, NY, USA.
Harvard Medical School, 2348Massachusetts General Hospital, Boston, MA, USA.
Global Spine J. 2021 Sep;11(7):1083-1088. doi: 10.1177/2192568220941451. Epub 2020 Aug 7.
Retrospective study.
Multiple studies have shown that osteoporotic patients are at an increased risk for medical and surgical complications, making optimal management of these patients challenging. The purpose of this study was to determine the relationship between patient age and the likelihood of surgical complications, mortality, and 30-day readmission rates following surgery for osteoporotic vertebral compression fractures (OVCFs).
A retrospective analysis of the American College of Surgeons National Surgery Quality Improvement Project (ACS-NSQIP) database from 2007 to 2014 identified 1979 patients who met inclusion criteria. A multivariate logistic regression analysis was conducted to calculate odds ratios (OR), with corresponding values and 95% confidence intervals, of the relationship between age (treated as a continuous variable) and perioperative mortality, surgical complications, and 30-day readmission rates.
Younger patients were statistically more likely to endure a minor (OR = 0.98; = .002) or major complication (OR = 0.97; = .009). The older a patient was, on the other hand, the higher the likelihood that patient would be readmitted within 30 days of surgery (OR =1.02; = .004). Mortality within the 30-day perioperative period was not statistically correlated with age.
The impact of age on adverse outcomes following surgery for OVCF is mixed. While younger patients are more likely to endure complications, older patients are more likely to be readmitted within 30 days following surgery. Patient age showed no correlation with mortality rates. In the setting of surgical treatment for an OVCF, a patient's age can help determine the risk of complications and the rate of readmission following intervention.
回顾性研究。
多项研究表明,骨质疏松症患者发生内科及外科并发症的风险增加,这使得对这些患者进行优化管理具有挑战性。本研究的目的是确定患者年龄与骨质疏松性椎体压缩骨折(OVCF)手术后手术并发症、死亡率及30天再入院率之间的关系。
对美国外科医师学会国家外科质量改进项目(ACS-NSQIP)2007年至2014年的数据库进行回顾性分析,确定了1979例符合纳入标准的患者。进行多因素逻辑回归分析,以计算年龄(作为连续变量处理)与围手术期死亡率、手术并发症及30天再入院率之间关系的比值比(OR),以及相应的P值和95%置信区间。
较年轻的患者在统计学上更有可能发生轻微(OR = 0.98;P = .002)或严重并发症(OR = 0.97;P = .009)。另一方面,患者年龄越大,术后30天内再次入院的可能性越高(OR = 1.02;P = .004)。围手术期30天内的死亡率与年龄在统计学上无相关性。
年龄对OVCF手术后不良结局的影响是复杂的。虽然较年轻的患者更有可能发生并发症,但老年患者在术后30天内更有可能再次入院。患者年龄与死亡率无相关性。在OVCF的手术治疗中,患者年龄有助于确定并发症风险及干预后的再入院率。