Risk factors for postoperative complication after spinal fusion and instrumentation in degenerative lumbar scoliosis patients

Journal of Orthopaedic Surgery and Research

Haodong Fei¹  Yue Xie¹  Shouguo Wang¹  Feng Ji¹  Jianfei Zhu²  Honghui Tang¹ 

[1] Department of Orthopedics, Huai'an First People's Hospital, Nanjing Medical University, 6 Beijing Road West, Huai’an, Jiangsu 223300, People's Republic of China;Department of Orthopedics, The 82nd Hospital of PLA, Huai’an 223300, People's Republic of China

关键词: Spinal fusion;    Predictive factors;    Postoperative complications;    Degenerative lumbar scoliosis;   

Others  :  813577
DOI  :  10.1186/1749-799X-9-15

 received in 2014-01-11, accepted in 2014-02-27,  发布年份 2014

【 摘 要 】

Background

Relatively few studies have focused on the major medical complications that are more common in older adults. Furthermore, these studies have generally not reported how accurately a risk factor, or combination of risk factors, can distinguish between those who will have a complication and those who will not.

Methods

A total of 236 consecutive patients who had undergone surgical treatment for degenerative lumbar scoliosis between June 2008 and June 2012 were included retrospectively in this study. The demographic distribution, medical history, and clinical data were collected to investigate the predictive factors of postoperative complications by logistic regression.

Results

Among 236 eligible patients, major medical complications occurred in 7.2% of cases and wound complications occurred in 1.7% of cases. Ninety-day mortality rate was 0.4%. Postoperative complications were strongly associated with history of severe chronic obstructive pulmonary disease (COPD) (P = 0.031), dyspnea with minimal exertion (P = 0.041), being at least partially dependent (P = 0.041), smoking within the past year (P = 0.044), American Society of Anesthesiologists (ASA) class of more than 2 (P = 0.000), diabetes treated with insulin (P = 0.003), and steroid use for chronic condition (P = 0.003). In logistic regressions, operation time (odds ratio 2.45, 95% confidence interval 1.11–4.78), ASA class (class 3 or 4 vs. class 1 or 2: odds ratio 2.21, 95% confidence interval 1.22–3.45), insulin-dependent diabetes (odds ratio 1.72, 95% confidence interval 1.18–2.43), and steroid use for chronic condition (odds ratio 1.55, 95% confidence interval 1.06–2.32) may be reasonable predictors for an individual's likelihood of surgical complications.

Conclusions

The occurrence of postoperative complications is most likely multifactorial and is related to operation time, ASA class, insulin-dependent diabetes and steroid use for chronic condition.

【 授权许可】

   
2014 Tang et al.; licensee BioMed Central Ltd.

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