Outcomes and national trends for the surgical treatment of lumbar Spine trauma

Doniel Drazin, Miriam A Nuno, Faris Shweikeh, Alexander R. Vaccaro, Eli Baron, Terrence T. Kim, J. Patrick Johnson

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Introduction. Operative treatment of lumbar spine compression fractures includes fusion and/or cement augmentation. Our aim was to evaluate postoperative differences in patients treated surgically with fusion, vertebroplasty, or kyphoplasty. Methods. The Nationwide Inpatient Sample Database search for adult vertebral compression fracture patients treated 2004-2011 identified 102,316 surgical patients: 30.6% underwent spinal fusion, 17.1% underwent kyphoplasty, and 49.9% underwent vertebroplasty. Univariate analysis of patient and hospital characteristics, by treatment, was performed. Multivariable analysis was used to determine factors associated with mortality, nonroutine discharge, complications, and patient safety. Results. Average patient age: fusion (46.2), kyphoplasty (78.5), vertebroplasty (76.7) (p <. 0001). Gender, race, household income, hospital-specific characteristics, and insurance differences were found (p ≤. 001). Leading comorbidities were hypertension, osteoporosis, and diabetes. Risks for higher mortality (OR 2.0: CI: 1.6-2.5), nonroutine discharge (OR 1.6, CI: 1.6-1.7), complications (OR 1.1, CI: 1.0-1.1), and safety related events (OR 1.1, CI: 1.0-1.1) rose consistently with increasing age, particularly among fusion patients. Preexisting comorbidities and longer in-hospital length of stay were associated with increased odds of nonroutine discharge, complications, and patient safety. Conclusions. Fusion patients had higher rates of poorer outcomes compared to vertebroplasty and kyphoplasty cohorts. Mortality, nonroutine discharge, complications, and adverse events increased consistently with older age.

Original languageEnglish (US)
Article number3623875
JournalBioMed Research International
Volume2016
DOIs
StatePublished - Jan 1 2016
Externally publishedYes

Fingerprint

Kyphoplasty
Spine
Fusion reactions
Vertebroplasty
Wounds and Injuries
Compression Fractures
Patient Safety
Therapeutics
Mortality
Comorbidity
Length of Stay
Insurance
Spinal Fusion
Medical problems
Cements
Compaction
Osteoporosis
Inpatients
Databases
Hypertension

ASJC Scopus subject areas

  • Immunology and Microbiology(all)
  • Biochemistry, Genetics and Molecular Biology(all)

Cite this

Drazin, D., Nuno, M. A., Shweikeh, F., Vaccaro, A. R., Baron, E., Kim, T. T., & Johnson, J. P. (2016). Outcomes and national trends for the surgical treatment of lumbar Spine trauma. BioMed Research International, 2016, [3623875]. https://doi.org/10.1155/2016/3623875

Outcomes and national trends for the surgical treatment of lumbar Spine trauma. / Drazin, Doniel; Nuno, Miriam A; Shweikeh, Faris; Vaccaro, Alexander R.; Baron, Eli; Kim, Terrence T.; Johnson, J. Patrick.

In: BioMed Research International, Vol. 2016, 3623875, 01.01.2016.

Research output: Contribution to journalArticle

Drazin, Doniel ; Nuno, Miriam A ; Shweikeh, Faris ; Vaccaro, Alexander R. ; Baron, Eli ; Kim, Terrence T. ; Johnson, J. Patrick. / Outcomes and national trends for the surgical treatment of lumbar Spine trauma. In: BioMed Research International. 2016 ; Vol. 2016.
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abstract = "Introduction. Operative treatment of lumbar spine compression fractures includes fusion and/or cement augmentation. Our aim was to evaluate postoperative differences in patients treated surgically with fusion, vertebroplasty, or kyphoplasty. Methods. The Nationwide Inpatient Sample Database search for adult vertebral compression fracture patients treated 2004-2011 identified 102,316 surgical patients: 30.6{\%} underwent spinal fusion, 17.1{\%} underwent kyphoplasty, and 49.9{\%} underwent vertebroplasty. Univariate analysis of patient and hospital characteristics, by treatment, was performed. Multivariable analysis was used to determine factors associated with mortality, nonroutine discharge, complications, and patient safety. Results. Average patient age: fusion (46.2), kyphoplasty (78.5), vertebroplasty (76.7) (p <. 0001). Gender, race, household income, hospital-specific characteristics, and insurance differences were found (p ≤. 001). Leading comorbidities were hypertension, osteoporosis, and diabetes. Risks for higher mortality (OR 2.0: CI: 1.6-2.5), nonroutine discharge (OR 1.6, CI: 1.6-1.7), complications (OR 1.1, CI: 1.0-1.1), and safety related events (OR 1.1, CI: 1.0-1.1) rose consistently with increasing age, particularly among fusion patients. Preexisting comorbidities and longer in-hospital length of stay were associated with increased odds of nonroutine discharge, complications, and patient safety. Conclusions. Fusion patients had higher rates of poorer outcomes compared to vertebroplasty and kyphoplasty cohorts. Mortality, nonroutine discharge, complications, and adverse events increased consistently with older age.",
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