Risk factors related to perioperative systemic complications and mortality in elderly patients with osteoporotic vertebral fractures-analysis of a large national inpatient database.

Abstract

BACKGROUND:

The surgical treatment of osteoporotic vertebral fractures (OVF) is generally associated with a high risk of complications due to an aging population with osteoporosis; however, the detailed risk factors for systemic complications and mortality have not been clarified. We evaluated the risk factors for systemic complications and mortality in surgically treated OVF patients using a large national inpatient database.

METHODS:

Patients over 65 years old who were diagnosed with OVF and received either anterior fusion (AF) or posterior fusion (PF), from 2012 to 2016, were extracted from the diagnosis procedure combination (DPC) database. In each of the perioperative systemic complications (+) or (-) group, and the in-hospital death (+) or (-) group, we surveyed the various risk factors related to perioperative systemic complications and in-hospital death.

RESULTS:

The significant factors associated with systemic complications were older age (OR 1.38, 95% CI 1.09-1.74), a lower activity of daily living score upon admission (OR 1.52, 95%CI 1.19-1.94), atrial fibrillation (OR 2.14, 95%CI 1.25-3.65), renal failure (OR 2.29, 95%CI 1.25-4.20), and surgical procedure (AF, OR 1.73, 95%CI 1.35-2.22). The significant explanatory variables for in-hospital death were revealed to be male sex (OR 3.26, 95%CI 1.20-8.87), a lower body mass index (OR 3.97, 95%CI 1.23-12.86), unscheduled admission (OR 3.52, 95%CI 1.17-10.63), atrial fibrillation (OR 8.31, 95%CI 2.25-30.70), renal failure (OR 7.15, 95%CI 1.32-38.77), and schizophrenia (OR 8.23, 95%CI 1.66-42.02).

CONCLUSIONS:

Atrial fibrillation and renal failure as preoperative comorbidities were common factors between perioperative systemic complications and mortality in elderly patients for OVF.

• Authors: Shingo Morishita, Toshitaka Yoshii, Atsushi Okawa, Hiroyuki Inose, Takashi Hirai, Masato Yuasa, Kiyohide Fushimi, Takeo Fujiwara
• Journal: Journal of orthopaedic surgery and research (J Orthop Surg Res) Vol. 15 Issue 1 Pg. 518 (Nov 10 2020) ISSN: 1749-799X [Electronic] England
• PMID: 33168046 (Publication Type: Journal Article)

Topics

• Activities of Daily Living
• Age Factors
• Aged
• Aged, 80 and over
• Atrial Fibrillation (epidemiology)
• Body Mass Index
• Comorbidity
• Databases, Factual
• Female
• Hospital Mortality
• Humans
• Inpatients
• Japan (epidemiology)
• Male
• Osteoporosis (complications)
• Perioperative Period
• Renal Insufficiency (epidemiology)
• Risk Factors
• Sex Factors
• Spinal Fractures (epidemiology, etiology, mortality, surgery)
• Spinal Fusion (methods)