Effects of age and comorbidities on complication rates and adverse outcomes after lumbar laminectomy in elderly patients.

Abstract:

STUDY DESIGN:This is a retrospective cohort study using the National Inpatient Sample database. OBJECTIVE:The objective is to report mortality and complications after lumbar laminectomy in the elderly. SUMMARY OF BACKGROUND DATA:As the population continues to age in the United States, it is important to consider the surgical complications and outcomes in the elderly. A review of the literature reveals controversy over the safety of lumbar laminectomy in the elderly and disagreement over estimates of risks in this population. METHODS:Outcome measures were abstracted from the National Inpatient Sample. Multivariate analysis was performed to analyze the effect of patient and hospital characteristics on outcome measures. RESULTS:A total of 471,215 patients underwent lumbar laminectomy without fusion for lumbar stenosis from 1993 to 2002. The in-hospital mortality rate was 0.17%, and the complication rate was 12.17%. Postoperative hemorrhage or hematoma (5.2%) and nonspecific renal complications (2.8%) were the most common complications. Complication and mortality rates increased with age and comorbidities with an 18.9% complication rate and 1.4% mortality rate in patients over the age of 85 with 3 or more comorbidities, 14.7% complication rate and 0.22% mortality rate in patients over 85 with no comorbidities, and only a 6% complication rate and 0.05% mortality rate in patient between 18 and 44 with no comorbidities. Multivariate analysis revealed increased odds of mortality with increasing number of comorbidities and complications in the greater than 85 year age group. Increasing age, number of comorbidities, complication rate, and female sex also increased the odds of discharge to institution other than home. CONCLUSION:Elderly patients with comorbidities are at a higher risk for complications and adverse outcome after lumbar spine surgery. The effects of age and comorbidities on patient outcomes have been quantified. This information is critical in counseling elderly patients about the risk of surgery in their age group.

journal_name

Spine (Phila Pa 1976)

journal_title

Spine

authors

Li G,Patil CG,Lad SP,Ho C,Tian W,Boakye M

doi

10.1097/BRS.0b013e3181714a44

subject

Has Abstract

pub_date

2008-05-15 00:00:00

pages

1250-5

issue

11

eissn

0362-2436

issn

1528-1159

pii

00007632-200805150-00015

journal_volume

33

pub_type

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