STUDY DESIGN: Retrospective database review. OBJECTIVE: To assess complication and mortality rates after lumbar spinal fusion surgery in patients with late stage renal disease. SUMMARY OF BACKGROUND DATA: Lumbar spinal fusion surgeries are common in elderly patients who are well-known to have increased comorbidity burden. Elderly patients with severe chronic kidney disease (CKD) represent a population with poorly understood mortality and complication rates after spine surgery. METHODS: Medicare data from the PearlDiver Database (2005-2012) was queried for patients who underwent primary 1-2 level posterolateral lumbar spine fusion surgeries. This cohort was divided into two study groups: a cohort with a preexisting diagnosis of late stage renal disease (N = 1654) and a control cohort of all other patients (N = 242,085). The control group was matched to the renal disease cohort by age, sex, and comorbidities. Moreover, 90-day complication rates and 90-day and 1-year mortality were assessed. RESULTS: The renal disease cohort had increased rates of all medical complications (21.3 vs. 14.2%; odds ratio, OR, 1.64; 95% confidence intervals, CI, 1.44 -1.85; P < 0.0001). Increased rates of infection (4.4 vs. 1.8%; OR 2.43; 95% CI 1.87 - 3.16; P < 0.0001) and procedure-day blood transfusions (20.7 vs. 14.7%; OR 1.51; 95% CI 1.33 - 1.72; P < 0.0001) were also observed in the renal disease cohort. Both 90-day (1.1 vs. 0.2%; OR 5.05; 95% CI 2.90-8.77; P < 0.0001) and 1-year mortality (1.9 vs. 0.7%; OR 2.77; 95% CI 1.87-4.11; P < 0.0001) were significantly higher in the renal disease group compared with the control group. CONCLUSION: Elderly patients with late-stage renal disease treated with 1-2 level posterolateral lumbar fusion have 1.6 times increased odds of experiencing a major medical complication within 3 months of surgery and 2.8 times increased odds of 1-year mortality when compared with matched controls. LEVEL OF EVIDENCE: 3.
STUDY DESIGN: Retrospective database review. OBJECTIVE: To assess complication and mortality rates after lumbar spinal fusion surgery in patients with late stage renal disease. SUMMARY OF BACKGROUND DATA: Lumbar spinal fusion surgeries are common in elderly patients who are well-known to have increased comorbidity burden. Elderly patients with severe chronic kidney disease (CKD) represent a population with poorly understood mortality and complication rates after spine surgery. METHODS: Medicare data from the PearlDiver Database (2005-2012) was queried for patients who underwent primary 1-2 level posterolateral lumbar spine fusion surgeries. This cohort was divided into two study groups: a cohort with a preexisting diagnosis of late stage renal disease (N = 1654) and a control cohort of all other patients (N = 242,085). The control group was matched to the renal disease cohort by age, sex, and comorbidities. Moreover, 90-day complication rates and 90-day and 1-year mortality were assessed. RESULTS: The renal disease cohort had increased rates of all medical complications (21.3 vs. 14.2%; odds ratio, OR, 1.64; 95% confidence intervals, CI, 1.44 -1.85; P < 0.0001). Increased rates of infection (4.4 vs. 1.8%; OR 2.43; 95% CI 1.87 - 3.16; P < 0.0001) and procedure-day blood transfusions (20.7 vs. 14.7%; OR 1.51; 95% CI 1.33 - 1.72; P < 0.0001) were also observed in the renal disease cohort. Both 90-day (1.1 vs. 0.2%; OR 5.05; 95% CI 2.90-8.77; P < 0.0001) and 1-year mortality (1.9 vs. 0.7%; OR 2.77; 95% CI 1.87-4.11; P < 0.0001) were significantly higher in the renal disease group compared with the control group. CONCLUSION: Elderly patients with late-stage renal disease treated with 1-2 level posterolateral lumbar fusion have 1.6 times increased odds of experiencing a major medical complication within 3 months of surgery and 2.8 times increased odds of 1-year mortality when compared with matched controls. LEVEL OF EVIDENCE: 3.
Authors: Francesca Barile; Alberto Ruffilli; Michele Fiore; Marco Manzetti; Giuseppe Geraci; Giovanni Viroli; Cesare Faldini Journal: Int J Spine Surg Date: 2022-07-14
Authors: Sara Lener; Christoph Wipplinger; Anna Stocsits; Sebastian Hartmann; Anja Hofer; Claudius Thomé Journal: Acta Neurochir (Wien) Date: 2020-07-29 Impact factor: 2.216
Authors: Gregory Wyatt Poorman; John Y Moon; Charles Wang; Samantha R Horn; Bryan M Beaubrun; Olivia J Bono; Anne-Marie Francis; Cyrus M Jalai; Peter G Passias Journal: Int J Spine Surg Date: 2018-10-15