Perioperative complications in patients aged ≥85 years undergoing spinal surgery: a retrospective comparative study of pre-old and old patients in Japan.

IF 2.3 Q2 ORTHOPEDICS Asian Spine Journal Pub Date : 2024-10-22 DOI:10.31616/asj.2024.0215
Takahiro Mui, Hideki Shigematsu, Masaki Ikejiri, Sachiko Kawasaki, Yasuhito Tanaka
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Abstract

Study design: A retrospective comparative study.

Purpose: To compare the characteristics of perioperative complications in patients aged ≥85 years with those of younger patients undergoing similar spine surgery and examine factors associated with perioperative complications and clinical outcomes among patients aged ≥85 years.

Overview of literature: The risk factors for perioperative complications and their effect on outcomes in patients aged ≥85 years remain unclear. Furthermore, no study has compared younger patients with similar surgeries and condition with those aged ≥85 years.

Methods: The study included patients aged ≥65 years who underwent spinal surgeries. The patients aged ≥85, 75-84, and 65-74 years were categorized into the super-old, old, and pre-old groups, respectively. The differences in perioperative age-related complications were compared among the three groups while matching for surgical procedures and general conditions (study 1). Furthermore, preoperative and intraoperative factors were examined for perioperative complications in the super-old group (study 2). Complications were categorized into surgical site and systemic complications.

Results: The analysis included 44 patients from each group. In study 1, the total complication rates were 40.9%, 25%, and 18.2% of the super-old, old, and pre-old groups, respectively. Differences in complication rates were observed between the super-old and pre-old groups (p=0.011). In study 2, 58 patients from the super-old group were analyzed. Surgical site complications were significantly associated with longer surgical duration (p=0.02) and more estimated blood loss (p=0.003). Systemic complications were significantly associated with previous cerebrovascular disease (p=0.014), preoperative motor deficit (p=0.023), and emergency case (p=0.006) and negatively associated with diabetes mellitus (p=0.048).

Conclusions: Perioperative complications increased with advancing age in the super-old, old, and pre-old groups. The complication type is associated with specific background factors; therefore, determining them may help prevent perioperative complications.

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接受脊柱手术的≥85岁患者围手术期并发症:日本老年前和老年患者的回顾性比较研究。
研究设计目的:比较年龄≥85 岁患者与接受类似脊柱手术的年轻患者围手术期并发症的特征,并研究与年龄≥85 岁患者围手术期并发症和临床预后相关的因素:≥85岁患者围手术期并发症的风险因素及其对预后的影响仍不清楚。此外,还没有研究将手术和病情相似的年轻患者与年龄≥85 岁的患者进行比较:研究对象包括年龄≥65 岁、接受过脊柱手术的患者。将年龄≥85 岁、75-84 岁和 65-74 岁的患者分别分为超高龄组、高龄组和高龄前组。比较了三组患者围手术期年龄相关并发症的差异,同时匹配了手术方法和一般情况(研究 1)。此外,还研究了超高龄组围手术期并发症的术前和术中因素(研究 2)。并发症分为手术部位并发症和全身并发症:结果:分析包括每组的 44 名患者。在研究 1 中,超高龄组、高龄组和高龄前组的总并发症发生率分别为 40.9%、25% 和 18.2%。超高龄组和高龄前组的并发症发生率存在差异(P=0.011)。研究 2 分析了超高龄组的 58 名患者。手术部位并发症与手术时间较长(p=0.02)和估计失血量较多(p=0.003)明显相关。全身并发症与既往脑血管疾病(p=0.014)、术前运动障碍(p=0.023)和急诊病例(p=0.006)明显相关,与糖尿病呈负相关(p=0.048):结论:在超高龄组、高龄组和高龄前期组中,围手术期并发症随着年龄的增长而增加。并发症的类型与特定的背景因素有关,因此,确定这些因素有助于预防围手术期并发症。
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来源期刊
Asian Spine Journal
Asian Spine Journal ORTHOPEDICS-
CiteScore
5.10
自引率
4.30%
发文量
108
审稿时长
24 weeks
期刊最新文献
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