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Morbidity, mortality, and readmission after vertebral augmentation: analysis of 850 patients from the American College of Surgeons National Surgical Quality Improvement Program database.
Spine (Phila Pa 1976). 2014 Nov 01; 39(23):1943-9.S

Abstract

STUDY DESIGN

Retrospective cohort study.

OBJECTIVE

To identify risk factors for poor short-term outcomes after vertebral augmentation procedures.

SUMMARY OF BACKGROUND DATA

Vertebral compression fractures are the most common fractures of osteoporosis and are frequently treated with vertebroplasty or kyphoplasty. There is a shortage of information about risk factors for short-term, general health outcomes after vertebral augmentation in the literature.

METHODS

Patients older than 65 years who underwent vertebroplasty or kyphoplasty in 2011 and 2012 were identified from the American College of Surgeons National Surgical Quality Improvement Program database. Patient characteristics were tested for association with 30-day adverse events, mortality, and readmission using bivariate and multivariate analyses.

RESULTS

A total of 850 patients met inclusion criteria. The average age was 78.9±11.7 years (mean±standard deviation) and females made up 70.8% of the cohort. Of these patients, 9.5% had any adverse event (AAE), and 6.6% had a serious adverse event (SAE). Death occurred in 1.5% of patients, and 10.8% were readmitted within the first 30 postoperative days.On multivariate analysis, AAE and SAE were both significantly associated with American Society of Anesthesiologists class 4 (AAE: odds ratio [OR]=2.7, P=0.013; SAE: OR=2.5, P=0.040) and inpatient status before procedure (AAE: OR=2.7, P<0.001, SAE: OR=2.4, P=0.003). Increased postoperative mortality rate was associated with American Society of Anesthesiologists class 4 (OR=6.4, P=0.024) and the use of nongeneral anesthesia (OR=4.0, P=0.022). Readmission was associated with history of pulmonary disease (OR=2.0, P=0.005) and inpatient status before procedure (OR=1.9, P=0.005).

CONCLUSION

Adverse general health outcomes were relatively common, and the factors identified in the earlier text associated with patient outcomes after vertebral augmentation may be useful for preoperative discussions and counseling.

LEVEL OF EVIDENCE

3.

Authors+Show Affiliations

From the Department of Orthopaedics and Rehabilitation, Yale University School of Medicine, New Haven, CT.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

25188603

Citation

Toy, Jason O., et al. "Morbidity, Mortality, and Readmission After Vertebral Augmentation: Analysis of 850 Patients From the American College of Surgeons National Surgical Quality Improvement Program Database." Spine, vol. 39, no. 23, 2014, pp. 1943-9.
Toy JO, Basques BA, Grauer JN. Morbidity, mortality, and readmission after vertebral augmentation: analysis of 850 patients from the American College of Surgeons National Surgical Quality Improvement Program database. Spine. 2014;39(23):1943-9.
Toy, J. O., Basques, B. A., & Grauer, J. N. (2014). Morbidity, mortality, and readmission after vertebral augmentation: analysis of 850 patients from the American College of Surgeons National Surgical Quality Improvement Program database. Spine, 39(23), 1943-9. https://doi.org/10.1097/BRS.0000000000000563
Toy JO, Basques BA, Grauer JN. Morbidity, Mortality, and Readmission After Vertebral Augmentation: Analysis of 850 Patients From the American College of Surgeons National Surgical Quality Improvement Program Database. Spine. 2014 Nov 1;39(23):1943-9. PubMed PMID: 25188603.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Morbidity, mortality, and readmission after vertebral augmentation: analysis of 850 patients from the American College of Surgeons National Surgical Quality Improvement Program database. AU - Toy,Jason O, AU - Basques,Bryce A, AU - Grauer,Jonathan N, PY - 2014/9/5/entrez PY - 2014/9/5/pubmed PY - 2015/7/21/medline SP - 1943 EP - 9 JF - Spine JO - Spine VL - 39 IS - 23 N2 - STUDY DESIGN: Retrospective cohort study. OBJECTIVE: To identify risk factors for poor short-term outcomes after vertebral augmentation procedures. SUMMARY OF BACKGROUND DATA: Vertebral compression fractures are the most common fractures of osteoporosis and are frequently treated with vertebroplasty or kyphoplasty. There is a shortage of information about risk factors for short-term, general health outcomes after vertebral augmentation in the literature. METHODS: Patients older than 65 years who underwent vertebroplasty or kyphoplasty in 2011 and 2012 were identified from the American College of Surgeons National Surgical Quality Improvement Program database. Patient characteristics were tested for association with 30-day adverse events, mortality, and readmission using bivariate and multivariate analyses. RESULTS: A total of 850 patients met inclusion criteria. The average age was 78.9±11.7 years (mean±standard deviation) and females made up 70.8% of the cohort. Of these patients, 9.5% had any adverse event (AAE), and 6.6% had a serious adverse event (SAE). Death occurred in 1.5% of patients, and 10.8% were readmitted within the first 30 postoperative days.On multivariate analysis, AAE and SAE were both significantly associated with American Society of Anesthesiologists class 4 (AAE: odds ratio [OR]=2.7, P=0.013; SAE: OR=2.5, P=0.040) and inpatient status before procedure (AAE: OR=2.7, P<0.001, SAE: OR=2.4, P=0.003). Increased postoperative mortality rate was associated with American Society of Anesthesiologists class 4 (OR=6.4, P=0.024) and the use of nongeneral anesthesia (OR=4.0, P=0.022). Readmission was associated with history of pulmonary disease (OR=2.0, P=0.005) and inpatient status before procedure (OR=1.9, P=0.005). CONCLUSION: Adverse general health outcomes were relatively common, and the factors identified in the earlier text associated with patient outcomes after vertebral augmentation may be useful for preoperative discussions and counseling. LEVEL OF EVIDENCE: 3. SN - 1528-1159 UR - https://www.unboundmedicine.com/medline/citation/25188603/Morbidity_mortality_and_readmission_after_vertebral_augmentation:_analysis_of_850_patients_from_the_American_College_of_Surgeons_National_Surgical_Quality_Improvement_Program_database_ L2 - http://dx.doi.org/10.1097/BRS.0000000000000563 DB - PRIME DP - Unbound Medicine ER -