Life-threatening perioperative complications among older adults with spinal metastases: An analysis based on a nationwide inpatient sample of the US.
Publication Title
J Geriatr Oncol
Document Type
Article
Publication Date
9-1-2023
Keywords
washington; Aged, 80 and over; Humans; Male; United States; Aged; Spinal Neoplasms; Inpatients; Hospitalization; Comorbidity; Risk Factors; Postoperative Complications; Retrospective Studies
Abstract
INTRODUCTION: We aimed to investigate the prognostic determinants of life-threatening and fatal complications in patients= 20 years of age and those =80 years who were undergoing surgery for spinal metastases.
MATERIALS AND METHODS: Based on data between 2005 and 2018 extracted from National Inpatient Sample as the largest longitudinal hospital inpatient databases in the United States, statistical analyses were performed to identify prognostic factors (age, sex, household income, insurance status, major comorbidities, primary site of malignancy, types of surgery, surgical approaches, types of hospital admission, and hospital-related characteristics) for major and fatal perioperative complications among older adult patients.
RESULTS: A total of 31,925 patients aged = 20y who were undergoing surgery for spinal metastasis were identified (< 80 y: n = 28,448; = 80 y: n = 35,37). After adjustment, age =80 y was significantly associated with greater risk of perioperative cardiac arrest (adjusted odds ratio [aOR]: 1.34, 95% confidence interval [CI]: 1.03-1.73) and acute kidney injury (AKI) (aOR: 1.23, 95% CI: 1.07-1.41) but lower risk of venous thromboembolic event (VTE) (aOR: 0.80, 95% CI: 0.66-0.96) than
DISCUSSION: This study identifies a list of independent risk factors for the presence of life-threatening complications among patients= 80y who were undergoing surgery for spinal metastasis. The findings contribute to the development of clinical strategies for the surgical management of spinal metastasis, especially for octogenarians, and lower the risk of unfavorable inpatient outcomes.
Area of Special Interest
Cancer
Area of Special Interest
Orthopedics & Sports Medicine
Specialty/Research Institute
Geriatrics
Specialty/Research Institute
Oncology
Specialty/Research Institute
Orthopedics
DOI
10.1016/j.jgo.2023.101597
