TY - JOUR
T1 - Impact of Chronic Obstructive Pulmonary Disease on Postoperative Complication Rates, Ambulation, and Length of Hospital Stay After Elective Spinal Fusion (≥3 Levels) in Elderly Spine Deformity Patients
AU - Elsamadicy, Aladine A.
AU - Sergesketter, Amanda R.
AU - Kemeny, Hanna
AU - Adogwa, Owoicho
AU - Tarnasky, Aaron
AU - Charalambous, Lefko
AU - Lubkin, David E.T.
AU - Davison, Mark A.
AU - Cheng, Joseph
AU - Bagley, Carlos A.
AU - Karikari, Isaac O.
N1 - Publisher Copyright:
© 2018 Elsevier Inc.
PY - 2018/8
Y1 - 2018/8
N2 - Objective: To investigate the impact that chronic obstructive pulmonary disease (COPD) has on postoperative complication rates, ambulation, and hospital length of stay for elderly spinal deformity patients after elective spinal fusion (≥3 levels). Methods: The medical records of 559 elderly (≥60 years old) spine deformity patients undergoing elective spinal fusion (≥3 levels) at a major academic institution from 2005 to 2015 were reviewed. We identified 60 patients with COPD (10.7%) and 499 patients without COPD (89.3%). Patient demographics, comorbidities, postoperative complications, ambulatory status, and readmission rates were collected. The primary outcomes investigated in this study were complication rates and length of hospital stay. Results: Demographics and comorbidities were similar between groups, with a difference in proportion of smokers (COPD group: 25.0% vs. no COPD group: 9.6%, P = 0.0004). The median number of fusion levels (P = 0.840), operative time (P = 0.842), estimated blood loss (P = 0.336), and incidences of durotomy (P = 0.258) was similar between both cohorts. The COPD cohort experienced a higher rate of postoperative fever (10.0% vs. 3.0%, P = 0.007) and pneumonia (5.0% vs. 0.4%, P = 0.0004), respectively. There was a significant difference in the number of feet walked on the first day of ambulation after surgery (COPD group: 58.6 ± 78.4 vs. no COPD group: 84.0 ± 102.8, P = 0.040). Length of hospital stay was significantly longer in the COPD cohort than the no COPD cohort (7.7 ± 6.4 vs. 6.0 ± 4.0 days, respectively; P = 0.0498). Conclusions: Our study demonstrates that elderly patients with COPD have increased lengths of stay and higher rates of postoperative pneumonia after spinal fusion. This determination identifies a potentially modifiable risk factor for increased utilization of health care resources.
AB - Objective: To investigate the impact that chronic obstructive pulmonary disease (COPD) has on postoperative complication rates, ambulation, and hospital length of stay for elderly spinal deformity patients after elective spinal fusion (≥3 levels). Methods: The medical records of 559 elderly (≥60 years old) spine deformity patients undergoing elective spinal fusion (≥3 levels) at a major academic institution from 2005 to 2015 were reviewed. We identified 60 patients with COPD (10.7%) and 499 patients without COPD (89.3%). Patient demographics, comorbidities, postoperative complications, ambulatory status, and readmission rates were collected. The primary outcomes investigated in this study were complication rates and length of hospital stay. Results: Demographics and comorbidities were similar between groups, with a difference in proportion of smokers (COPD group: 25.0% vs. no COPD group: 9.6%, P = 0.0004). The median number of fusion levels (P = 0.840), operative time (P = 0.842), estimated blood loss (P = 0.336), and incidences of durotomy (P = 0.258) was similar between both cohorts. The COPD cohort experienced a higher rate of postoperative fever (10.0% vs. 3.0%, P = 0.007) and pneumonia (5.0% vs. 0.4%, P = 0.0004), respectively. There was a significant difference in the number of feet walked on the first day of ambulation after surgery (COPD group: 58.6 ± 78.4 vs. no COPD group: 84.0 ± 102.8, P = 0.040). Length of hospital stay was significantly longer in the COPD cohort than the no COPD cohort (7.7 ± 6.4 vs. 6.0 ± 4.0 days, respectively; P = 0.0498). Conclusions: Our study demonstrates that elderly patients with COPD have increased lengths of stay and higher rates of postoperative pneumonia after spinal fusion. This determination identifies a potentially modifiable risk factor for increased utilization of health care resources.
KW - Ambulation
KW - Chronic obstructive pulmonary disease
KW - Elderly
KW - Length of stay
KW - Postoperative complications
KW - Spinal Deformity
KW - Spinal Fusion
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U2 - 10.1016/j.wneu.2018.05.185
DO - 10.1016/j.wneu.2018.05.185
M3 - Article
C2 - 29870850
AN - SCOPUS:85048934207
SN - 1878-8750
VL - 116
SP - e1122-e1128
JO - World neurosurgery
JF - World neurosurgery
ER -