Incidence and risk factors for multiple medical complications in adult degenerative scoliosis long-level fusion.

Adult degenerative scoliosis (ADS) surgery is known for its high incidence of complications. The propose of this study was to determine current complication rates and the predictors of medical complications in surgical ASD patients. A retrospective study of 153 ADS patients who underwent long level spinal fusion with 2-year follow-up between 2012 and 2017. The patient- and surgical-related risk factors for each individual medical complication were identified by using univariate testing. All patients were divided into groups with and without medical complication, infection, neurological complications, and cardiopulmonary complications, respectively. Potential risk factors were identified using univariate testing. Multivariate Logistic regression was used to evaluate independent predictors of medical complications. The total medical complication incidence was 26.1%. Patient-related independent risk factors for the development of medical complications included diabetes, smoking; for infection were diabetes and smoking; for neurological complications were BMI and diabetes; for cardiopulmonary complications were hypertension, smoking and cardiac comorbidity. Surgical-related independent risk factors for the development of medical complications were fusion level, operative time, osteotomy, blood transfusion and LOS; for infection were fusion level, blood transfusion, and LOS; for neurological complication were fusion level, osteotomy and blood transfusion; for cardiopulmonary complication were fusion level. Diabetes and smoking were the most common patient-related independent risk factors increase the development of each individual medical complication. On the other hand, fusion levels and blood transfusion were the most common surgical-related independent risk factors increase the development of each individual medical complication. Prevention of these risk factors can reduce the incidence of complications in Chinese patients with ADS surgery.