Complications of Spine Surgery in Elderly Japanese Patients: Implications for Future of World Population Aging

被引:21
作者
Umekawa, Motoyuki [1 ]
Takai, Keisuke [1 ]
Taniguchi, Makoto [1 ]
机构
[1] Tokyo Metropolitan Neurol Hosp, Dept Neurosurg, 2-6-1 Musashidai, Fuchu, Tokyo 1830042, Japan
关键词
Aging society; Perioperative complication; Medical complication; Surgical complication; Morbidity; Mortality; MEDICAL COMPLICATIONS; LUMBAR DECOMPRESSION; PATIENTS OLDER; RISK-FACTORS; STENOSIS; AGE; MYELOPATHY; OUTCOMES;
D O I
10.14245/ns.1938184.092
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Objective: To analyze the relationship between age and perioperative complications of spine surgery in a Japanese cohort with the longest average life expectancy in the world. Methods: Patients with spinal stenosis who underwent standard spine surgery without instrumented fusion were divided into 4 groups: adults (20-64 years), the young-old (6574), the middle old (75-84), and the oldest-old (>= 85). Data on medical complications, surgical complications, and deaths within 30 days of index surgery were compared across the groups. Risk factors for complications were identified through multivariate analysis. Results: A total of 584 patients underwent 673 operations: 35% were performed on adult patients, 33% on the young-old, 27% on the middle old, and 5% on the oldest-old. The rates of total or [major] medical complications significantly increased with age (8% [0.8%], 11% [0.9%], 27% [3.9%], 45% [9.1%], respectively; p<0.001 [p=0.003]), whereas those of surgical complications did not differ (11%, 8.1%, 14%, 9.1%, respectively; p=0.25). Independent risk factors for medical complications were an age of 75 years or older (75-84: odds ratio [OR], 5.1; >= 85: OR, 6.2) and American Society of Anesthesiologists (ASA) physical status classification III (OR, 5.4). Two patients older than 85 years died from medical complications. Conclusion: The complications of spine surgery increased in the middle and oldest-old patients because of medical complications; however, most were minor and treatable. Major complications were associated with preoperative medical comorbidities and their severities; therefore, most elderly patients with low ASA physical status classification (<= II) may benefit from spine surgery.
引用
收藏
页码:780 / 788
页数:9
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