软骨发育不全患者在椎板切除术后发生 90 天不良事件的风险更高:使用国家数据库进行匹配比较。

IF 1.6 Q3 CLINICAL NEUROLOGY Spine deformity Pub Date : 2024-10-09 DOI:10.1007/s43390-024-00977-x
Anusha Patil, Peter Y Joo, Jay Moran, Lancelot Benn, Addisu Mesfin
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引用次数: 0

摘要

目的:对软骨发育不全(一种常见的骨骼发育不良)患者实施椎板切除术可能会带来独特的挑战。有关软骨发育不全患者椎板切除术不良反应的研究报告数量有限。目的:比较软骨发育不良患者和非软骨发育不良患者椎板切除术后 90 天的不良反应:使用 2010-2020 年 PearlDiver Mariner 91 管理数据库进行回顾性队列研究,以确定接受胸椎、胸腰椎或腰椎椎板切除术的患者。根据年龄、性别、保险和 ECI,软骨发育不全患者与非软骨发育不全患者按 1:4 配对。单变量和多变量逻辑回归分析评估并比较了90天不良事件。报告了概率比 (OR)、95% 置信区间 (CI) 和 p 值,显著性设置为 p 结果:多变量分析显示,与无软骨发育不全的患者相比,实施椎板切除术的软骨发育不全患者发生 90 天不良事件的几率是后者的 2.82 倍(p 结论:该研究采用了最大规模的队列研究,对软骨发育不全患者的 90 天不良事件进行了比较:本研究使用了一个最大的队列来比较接受椎板切除术的软骨发育不全患者和非软骨发育不全患者。研究发现,软骨发育不全患者在接受椎板切除术后发生 90 天不良事件的风险明显高于无软骨发育不全的匹配队列患者。
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Patients with achondroplasia have increased risk of 90-day adverse events following laminectomy: A matched comparison using a national database.

Purpose: Performing laminectomies in patients with achondroplasia-a common skeletal dysplasia-can present unique challenges. There are a limited number of studies that have reported on the adverse effects of laminectomies in patients with achondroplasia. To compare the 90-day postoperative adverse events following laminectomy in patients with and without achondroplasia.

Methods: Retrospective cohort study using the 2010-2020 PearlDiver Mariner 91 administrative database was used to identify patients who underwent thoracic, thoracolumbar, or lumbar laminectomy. Patients with achondroplasia were matched 1:4 to patients without achondroplasia based on age, sex, insurance, and ECI. Univariate and multivariate logistic regression analyses assessed and compared 90-day adverse events. Odds ratios (OR), 95% confidence intervals (CI), and p-values were reported with significance set at p < 0.05.

Results: A multivariate analysis revealed that when laminectomy was performed, patients with achondroplasia were 2.82 times more likely to have 90-day AE compared to those without achondroplasia (p < 0.001). When comparing individual subtypes of adverse events, patients with achondroplasia were found to have significantly greater odds of a transfusion (OR 6.40, p < 0.001), UTI (OR 3.79, p < 0.001), disruption of wound (OR 3.71, p < 0.001), and hematoma (OR 2.94, p = 0.032). Pneumonia, cardiac arrest, AKI, other perioperative events, durotomy, and VTE were not significantly different between the two cohorts.

Conclusion: This study uses one of the largest cohorts to compare patients with and without achondroplasia undergoing laminectomy. Patients with achondroplasia were found to have a significantly greater risk of 90-day adverse events following laminectomy compared to their matched cohort of patients without achondroplasia.

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来源期刊
CiteScore
3.20
自引率
18.80%
发文量
167
期刊介绍: Spine Deformity the official journal of the?Scoliosis Research Society is a peer-refereed publication to disseminate knowledge on basic science and clinical research into the?etiology?biomechanics?treatment?methods and outcomes of all types of?spinal deformities. The international members of the Editorial Board provide a worldwide perspective for the journal's area of interest.The?journal?will enhance the mission of the Society which is to foster the optimal care of all patients with?spine?deformities worldwide. Articles published in?Spine Deformity?are Medline indexed in PubMed.? The journal publishes original articles in the form of clinical and basic research. Spine Deformity will only publish studies that have institutional review board (IRB) or similar ethics committee approval for human and animal studies and have strictly observed these guidelines. The minimum follow-up period for follow-up clinical studies is 24 months.
期刊最新文献
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