Complication rate up for elderly undergoing spinal fusion

(HealthDay)—Patients aged 65 years or older have a higher likelihood of complications when undergoing anterior cervical discectomy and fusion (ACDF), compared to younger patients, according to research published in the Dec. 1 issue of Spine.

Rafael A. Buerba, M.D., from the Yale University School of Medicine in New Haven, Conn., and colleagues conducted a retrospective cohort analysis to characterize 30-day postoperative outcomes in elderly patients undergoing ACDF. Data were included for 6,253 patients who underwent ACDF, stratified into four age groups: 18 to 39 years, 40 to 64 years, 65 to 74 years, and 75 years or older.

Using multivariate logistic regression, the researchers found that the likelihood of having blood transfusions, reoperations, urinary complications, extended length of stays, and one or more complication was increased for both groups of elderly patients (65 to 74 years and 75 years or older). The likelihood of pulmonary embolism/deep vein thrombosis was increased only for patients aged 65 to 74 years, while the likelihood of experiencing respiratory complications, central nervous system complications, or death was increased only for patients aged 75 years or older. The complication rates did not differ for those aged 18 to 39 years and for those aged 40 to 64 years. Shorter operating room times were seen for those aged 18 to 39 years and for those aged 75 years or older.

"Surgeons should be aware of the increased risk of multiple complications for patients of advanced age in their surgical decision making," the authors write.

Relevant financial activities outside the submitted work were disclosed: consultancy, expert testimony, grants.