Galivanche Anoop R, Toombs Courtney, Adrados Murillo, David Wyatt B, Malpani Rohil, Saifi Comron, Whang Peter G, Grauer Jonathan N, Varthi Arya G
Department of Orthopaedics and Rehabilitation, Yale School of Medicine, New Haven, CT, USA.
Penn Orthopaedics, University of Pennsylvania, Philadelphia, PA, USA.
Neurospine. 2021 Mar;18(1):226-233. doi: 10.14245/ns.2040620.310. Epub 2021 Mar 31.
The objective of the current study was to perform a retrospective review of a national database to assess the safety of cement augmentation for vertebral compression fractures in geriatric populations in varying age categories.
The 2005-2016 National Surgical Quality Improvement Program databases were queried to identify patients undergoing kyphoplasty or vertebroplasty in the following age categories: 60-69, 70-79, 80-89, and 90+ years old. Demographic variables, comorbidity status, procedure type, provider specialty, inpatient/outpatient status, number of procedure levels, and periprocedure complications were compared between age categories using chi-square analysis. Multivariate logistic regressions controlling for patient and procedural variables were then performed to assess the relative periprocedure risks of adverse outcomes of patients in the different age categories relative to those who were 60-69 years old.
For the 60-69, 70-79, 80-89, and 90+ years old cohorts, 486, 822, 937, and 215 patients were identified, respectively. After controlling for patient and procedural variables, 30-day any adverse events, serious adverse events, reoperation, readmission, and mortality were not different for the respective age categories. Cases in the 80- to 89-year-old cohort were at increased risk of minor adverse events compared to cases in the 60- to 69-year-old cohort.
As the population ages, cement augmentation is being considered as a treatment for vertebral compression fractures in increasingly older patients. These results suggest that even the very elderly may be appropriately considered for these procedures (level of evidence: 3).
本研究的目的是对一个国家数据库进行回顾性分析，以评估不同年龄组老年人群椎体压缩骨折骨水泥强化治疗的安全性。
查询2005 - 2016年国家外科质量改进计划数据库，以确定接受椎体后凸成形术或椎体成形术的以下年龄组患者：60 - 69岁、70 - 79岁、80 - 89岁和90岁及以上。使用卡方分析比较年龄组之间的人口统计学变量、合并症状态、手术类型、医疗服务提供者专业、住院/门诊状态、手术节段数量和围手术期并发症。然后进行多因素逻辑回归分析，控制患者和手术变量，以评估不同年龄组患者相对于60 - 69岁患者围手术期不良结局的相对风险。
在60 - 69岁、70 - 79岁、80 - 89岁和90岁及以上队列中，分别确定了486例、822例、937例和215例患者。在控制患者和手术变量后，各年龄组的30天任何不良事件、严重不良事件、再次手术、再入院和死亡率无差异。与60 - 69岁队列中的病例相比，80 - 89岁队列中的病例发生轻微不良事件的风险增加。
随着人口老龄化，骨水泥强化治疗越来越多地被考虑用于治疗年龄越来越大的椎体压缩骨折患者。这些结果表明，即使是高龄患者也可能适合接受这些手术（证据级别：3）。
