HCPLive Network

Major Complications Predicted by Age, Back Surgery Type

 
THURSDAY, Sept. 19 (HealthDay News) -- American Society of Anesthesiologists (ASA) class, age, and type of back surgery are independent risk factors for major medical complications, according to research published in the Sept. 1 issue of Spine.

Richard A. Deyo, M.D., from the Oregon Health and Science University in Portland, and colleagues utilized the Veterans Affairs National Surgical Quality Improvement Program database to identify 12,154 patients who underwent surgery for a primary diagnosis of lumbar stenosis between 1998 and 2009. Major medical complications were defined using a composite which included acute myocardial infarction, stroke, pulmonary embolism, pneumonia, systemic sepsis, coma, and cardiac arrest.

The researchers found that major medical complications occurred in 2.1 percent of patients, wound complications in 3.2 percent, and 90-day mortality in 0.6 percent. There was a strong association with age and major medical complications, but not wound complications. Complications were also strongly predicted by ASA class as well as by insulin use, long-term corticosteroid use, and preoperative functional status. However, ASA class and age were the strongest predictors of major medical complications (odds ratio for ASA class 4 versus class 1 or 2, 2.97). Fusion procedures remained associated with higher medical complication rates than decompressions alone, when adjusting for comorbidity, age, and functional status (odds ratio, 2.85).

"These factors may help in selecting patients and planning procedures, improving patient safety," the authors write.

Abstract 

Full Text (subscription or payment may be required) 

Copyright © 2013 HealthDay. All rights reserved.
 

Further Reading
Minimally invasive and open multilevel hemilaminectomy are similar with respect to cost and improved quality of life measures for the treatment of degenerative lumbar spinal stenosis, according to a study published in the February issue of the Journal of Spinal Disorders & Techniques.
Almost half of patients whose primary care physicians recommend a lumbosacral or cervical spine magnetic resonance imaging scan go on to receive a surgical consultation, but few end up undergoing spinal surgery, according to research published in the Jan. 1 issue of Spine.
For patients with spinal stenosis without degenerative spondylolisthesis, predominance of back pain versus leg pain is associated with worse surgical outcomes, according to a study published in the Feb. 1 issue of Spine.
Electrophysiological abnormalities have been identified that are of some prognostic value in determining deteriorating clinical status over the long term for patients with mild-to-moderate lumbar spinal stenosis, according to research published in the December issue of the European Spine Journal.
A new study is underway seeking to treat chronic back pain and measuring the benefits of using surgically implanted interspinous spacers.
Researchers from Finland find high depressive burden is associated with greater disability from the time of lumbar spinal stenosis surgery, including the 5-year point.
Patients seeing a spine surgeon are most influenced by low back pain intensity when considering whether to proceed with spinal fusion surgery, according to a study published in the Jan. 15 issue of Spine.
More Reading