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30-day adverse outcomes, re-admissions and mortality following vertebroplasty/kyphoplasty.
Clin Neurol Neurosurg. 2018 11; 174:129-133.CN

Abstract

OBJECTIVES

Despite vertebral fractures being a common occurrence in elderly osteoporotic individuals, literature remains scant with regards to 30-day outcomes following vertebral augmentation for these injuries. We studied a national database of elderly osteoporotic patients who underwent vertebroplasty and kyphoplasty.

PATIENTS AND METHODS

The 2012-2014 ACS-NSQIP database was queried using CPT codes for vertebroplasty (22520, 22521 and 22522) and kyphoplasty (22523, 22524 and 22525). Patients undergoing concurrent spinal fusion and/or laminectomies/laminotomies/laminoplasties were removed from the study. Patients with missing data were also excluded from the study.

RESULTS

Following inclusion/exclusion criteria, a total of 2433 patients were included in the study out of which 242(9.9%) underwent vertebroplasty and 2191(90.1%) underwent kyphoplasty. Following adjusted analysis, having a dependent functional health status pre-operatively (OR 1.78; p = 0.010), pre-operative sepsis/SIRS (OR 2.52; p = 0.009), history of COPD (OR 1.62; p = 0.025), disseminated cancer (OR 1.94; p = 0.028), pre-operative wound infection (OR 3.47; p = 0.003) and inpatient admission status (OR 3.22; p < 0.001) were independent predictors of having any complication within 30-days of the procedure. Significant independent risk factors for 30-day mortality were functional health status prior to surgery (OR 2.92; p = 0.002), pre-operative dialysis use (OR 11.74; p = 0.003), Disseminated cancer (OR 7.09; p < 0.001), chronic steroid use (OR 3.59; p < 0.001), and inpatient admission status (OR 4.95; p < 0.001).

CONCLUSION

Vertebroplasty/Kyphoplasty is associated with significant adverse outcomes. Providers can utilize these data to better pre-operatively filter high-risk patients and tailor an appropriate peri-operative medical optimization program to enhance care to lower the risk of complications, readmissions and mortality from this procedure.

Authors+Show Affiliations

College of Medicine, The Ohio State University, United States.Department of Orthopaedics, The Ohio State University Wexner Medical Center, United States.Department of Orthopaedics, The Ohio State University Wexner Medical Center, United States.Department of Orthopaedics, The Ohio State University Wexner Medical Center, United States.Department of Orthopaedics, The Ohio State University Wexner Medical Center, United States.Department of Orthopaedics, The Ohio State University Wexner Medical Center, United States. Electronic address: Safdar.Khan@osumc.edu.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

30236639

Citation

Choo, Stephanie, et al. "30-day Adverse Outcomes, Re-admissions and Mortality Following Vertebroplasty/kyphoplasty." Clinical Neurology and Neurosurgery, vol. 174, 2018, pp. 129-133.
Choo S, Malik AT, Jain N, et al. 30-day adverse outcomes, re-admissions and mortality following vertebroplasty/kyphoplasty. Clin Neurol Neurosurg. 2018;174:129-133.
Choo, S., Malik, A. T., Jain, N., Yu, E., Kim, J., & Khan, S. N. (2018). 30-day adverse outcomes, re-admissions and mortality following vertebroplasty/kyphoplasty. Clinical Neurology and Neurosurgery, 174, 129-133. https://doi.org/10.1016/j.clineuro.2018.08.014
Choo S, et al. 30-day Adverse Outcomes, Re-admissions and Mortality Following Vertebroplasty/kyphoplasty. Clin Neurol Neurosurg. 2018;174:129-133. PubMed PMID: 30236639.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - 30-day adverse outcomes, re-admissions and mortality following vertebroplasty/kyphoplasty. AU - Choo,Stephanie, AU - Malik,Azeem Tariq, AU - Jain,Nikhil, AU - Yu,Elizabeth, AU - Kim,Jeffery, AU - Khan,Safdar N, Y1 - 2018/08/12/ PY - 2018/05/31/received PY - 2018/07/30/revised PY - 2018/08/07/accepted PY - 2018/9/22/pubmed PY - 2019/11/26/medline PY - 2018/9/22/entrez KW - 30 day outcomes KW - Kyphoplasty KW - Mortality KW - NSQIP KW - Readmissions KW - Vertebral augmentation KW - Vertebroplasty SP - 129 EP - 133 JF - Clinical neurology and neurosurgery JO - Clin Neurol Neurosurg VL - 174 N2 - OBJECTIVES: Despite vertebral fractures being a common occurrence in elderly osteoporotic individuals, literature remains scant with regards to 30-day outcomes following vertebral augmentation for these injuries. We studied a national database of elderly osteoporotic patients who underwent vertebroplasty and kyphoplasty. PATIENTS AND METHODS: The 2012-2014 ACS-NSQIP database was queried using CPT codes for vertebroplasty (22520, 22521 and 22522) and kyphoplasty (22523, 22524 and 22525). Patients undergoing concurrent spinal fusion and/or laminectomies/laminotomies/laminoplasties were removed from the study. Patients with missing data were also excluded from the study. RESULTS: Following inclusion/exclusion criteria, a total of 2433 patients were included in the study out of which 242(9.9%) underwent vertebroplasty and 2191(90.1%) underwent kyphoplasty. Following adjusted analysis, having a dependent functional health status pre-operatively (OR 1.78; p = 0.010), pre-operative sepsis/SIRS (OR 2.52; p = 0.009), history of COPD (OR 1.62; p = 0.025), disseminated cancer (OR 1.94; p = 0.028), pre-operative wound infection (OR 3.47; p = 0.003) and inpatient admission status (OR 3.22; p < 0.001) were independent predictors of having any complication within 30-days of the procedure. Significant independent risk factors for 30-day mortality were functional health status prior to surgery (OR 2.92; p = 0.002), pre-operative dialysis use (OR 11.74; p = 0.003), Disseminated cancer (OR 7.09; p < 0.001), chronic steroid use (OR 3.59; p < 0.001), and inpatient admission status (OR 4.95; p < 0.001). CONCLUSION: Vertebroplasty/Kyphoplasty is associated with significant adverse outcomes. Providers can utilize these data to better pre-operatively filter high-risk patients and tailor an appropriate peri-operative medical optimization program to enhance care to lower the risk of complications, readmissions and mortality from this procedure. SN - 1872-6968 UR - https://www.unboundmedicine.com/medline/citation/30236639/30_day_adverse_outcomes_re_admissions_and_mortality_following_vertebroplasty/kyphoplasty_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0303-8467(18)30325-1 DB - PRIME DP - Unbound Medicine ER -