Spine Surgery Outcomes in Elderly Patients Versus General Adult Patients in the United States: A MarketScan Analysis.

Document Type

Article

Publication Date

7-1-2017

Publication Title

World Neurosurg

Keywords

Adolescent; Adult; Age Factors; Aged; Aged, 80 and over; Databases, Factual; Decompression, Surgical; Diskectomy; Female; Hospital Mortality; Humans; Intervertebral Disc Degeneration; Laminectomy; Length of Stay; Male; Middle Aged; Postoperative Complications; Spinal Diseases; Spinal Fusion; Spinal Stenosis; United States; Young Adult

Abstract

OBJECTIVE: To compare spine surgery outcomes in elderly patients (80-103 years old) versus general adult patients (18-79 years-old) in the United States.

METHODS: Truven Health Analytics MarketScan Research Databases (2000-2012) were queried. Patients with a diagnosis of degenerative disease of the spine without concurrent spinal stenosis, spinal stenosis without concurrent degenerative disease, or degenerative disease with concurrent spinal stenosis and who had undergone decompression without fusion, fusion without decompression, or decompression with fusion procedures were included. Indirect outcome measures included length of stay, in-hospital mortality, in-hospital and 30-day complications, and discharge disposition.

RESULTS: Patients (N = 155,720) were divided into elderly (n = 10,232; 6.57%) and general adult (n = 145,488; 93.4%) populations. Mean length of stay was longer in elderly patients versus general adult patients (3.62 days vs. 3.11 days; P < 0.0001). In-hospital mortality was more common in elderly patients versus general adult patients (0.31% vs. 0.06%; P < 0.0001). In-hospital and 30-day complications were more common in elderly patients versus general adult patients (11.3% vs. 7.15% and 17.8% vs. 12.6%; P < 0.0001). Nonroutine discharge was more common in elderly patients versus general adult patients (33.7% vs. 16.2%; P < 0.0001).

CONCLUSIONS: Our results revealed significantly longer hospital stays, more in-hospital mortalities, and more in-hospital and 30-day complications after decompression without fusion, fusion without decompression, or decompression with fusion procedures in elderly patients.

Clinical Institute

Neurosciences (Brain & Spine)

Department

Neurosciences

Department

Surgery

Department

Geriatrics

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