Identification of an Operative Time Threshold for Substantially Increased Postoperative Complications Among Elderly Spine Surgery Patients
| Autor: | Matthew C. Findlay, Robert B. Kim, Wesley S. Warner, Brandon A. Sherrod, Seojin Park, Marcus D. Mazur, Mark A. Mahan |
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| Rok vydání: | 2023 |
| Předmět: | |
| Zdroj: | Global Spine Journal. :219256822211493 |
| ISSN: | 2192-5690 2192-5682 |
| DOI: | 10.1177/21925682221149390 |
| Popis: | Study Design Retrospective cohort study. Objectives To identify whether thresholds exist beyond which operative duration or age increases risks for complications among patients ≥65 years undergoing elective spine surgery. Methods Elective inpatient spine procedures unrelated to infection/trauma/tumor diagnoses in patients Results Among 87,705 patients stratified by operative duration, 30 day complication rates rose nonlinearly as operative duration increased, with a sharp rise after 4.0-4.9 hours (28.3% at 4.0-4.9 hours, 51.7% at ≥5 hours, P < .001). Multivariate analysis found operative duration was independently associated with increased risk of overall complications (odds ratio 1.10→1.69, P < .001) and medical complications (odds ratio 1.19→1.98, P < .001). Although complication rates rose by age (all P < .001), age was not independently predictive of overall complications within any operative duration group on multivariate analysis. Operative duration had a greater effect (η2 P = .067) than age (η2 P = .003) on overall complication rates. Conclusions Increased operative duration was strongly associated with 30 day complication rates, particularly beyond a threshold of 5 hours. Furthermore, operative duration had a notably larger effect on overall complication rates than age. |
| Databáze: | OpenAIRE |
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