Clinical Outcomes of Discectomy in Octogenarian Patients With Lumbar Disc Herniation

Nie, Hai; Hao, Jie; Peng, Chao; Ou, Yunsheng; Quan, Zhengxue; An, Hong

doi:10.1097/bsd.0b013e318236b92d

Cited by 30 publications

(23 citation statements)

References 17 publications

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“…12,17 Zheng and colleagues used multivariate analysis to study 112 patients who underwent revision posterior lumbar fusion between 1992 and 1999 and found that increasing age was the only significant predictor of a longer hospital stay. 17 A more recent study by Nie et al reports differences in LOS between age groups after lumbar discectomy.…”

Section: Discussionmentioning

confidence: 99%

“…17 A more recent study by Nie et al reports differences in LOS between age groups after lumbar discectomy. 12 …”

Section: Discussionmentioning

confidence: 99%

“…Previous studies have described individual factors that contribute to increased length of stay after spine surgery, such as morbid obesity, 8 metabolic syndrome, 9 black race, 10 open surgery versus minimally invasive surgery, 11 age, 12 chronic obstructive pulmonary disease (COPD), 13 antidepressant use, 14 unemployment, 15 chronic renal disease, 15 and intraoperative fluid volume. 16 However, these were generally small studies that examined isolated factors, leaving significant room for the effects of confounding variables.…”

Section: Introductionmentioning

confidence: 99%

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Using the ACS-NSQIP to Identify Factors Affecting Hospital Length of Stay After Elective Posterior Lumbar Fusion

Basques

Fu²,

Buerba³

et al. 2014

Spine

117

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Study Design Retrospective cohort study of the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database from 2005 to 2010 that included 1,861 patients who had undergone elective posterior lumbar fusion. Objective To characterize factors that were independently associated with increased hospital length of stay (LOS) in patients who had undergone elective posterior lumbar fusion. Summary of Background Data Posterior lumbar spine fusion is a common surgical procedure used to treat lumbar spine pathology. LOS is an important clinical variable and a major determinant of inpatient hospital costs. There is lack of studies in the literature using multivariate analysis to specifically examine the predictors of LOS after elective posterior lumbar fusion. Methods Patients who underwent elective posterior lumbar fusion from 2005 to 2010 were identified in the ACS-NSQIP database. Preoperative and intraoperative variables were extracted for each case and a multivariate linear regression was performed to assess the contribution of each variable to LOS. Results A total of 1,861 elective posterior lumbar fusion patients were identified. The average age for patients in this cohort was 60.6 ± 13.9 years (mean ± standard deviation [SD]) with a body mass index (BMI) of 30.3 ± 6.2 kg/m2. 44.7% of patients were male. LOS ranged from 0 days to 51 days. Multivariate linear regression identified age (p < 0.001), morbid obesity (BMI ≥ 40 kg/m2, p < 0.001), American Society of Anesthesiologists (ASA) class (p = 0.001), operative time (p < 0.001), multilevel procedure (p = 0.001), and intraoperative transfusion (p < 0.001) as significant predictors of extended LOS. Conclusion The identified preoperative and intraoperative variables associated with extended LOS after elective posterior lumbar fusion may be helpful to clinicians for patient counseling and postoperative planning.

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Section: Discussionmentioning

confidence: 99%

“…17 A more recent study by Nie et al reports differences in LOS between age groups after lumbar discectomy. 12 …”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Using the ACS-NSQIP to Identify Factors Affecting Hospital Length of Stay After Elective Posterior Lumbar Fusion

Basques

Fu²,

Buerba³

et al. 2014

Spine

117

View full text Add to dashboard Cite

show abstract

“…9 Previous studies have sought to identify factors that affect LOS associated with ASD surgical intervention: Hassanzadeh et al 10 reported no significant differences in duration of hospitalization between ASD surgical patients who underwent primary or revision surgery; McCarthy et al 9 found that mean LOS for ASD patients with primary idiopathic scoliosis was lower than for patients with primary degenerative scoliosis, primary sagittal plane deformity, and patients who underwent revision surgery. Individual risk factors for extended LOS have also been characterized in the context of spine surgery: morbid obesity, 11 age, 12 and minimally invasive surgery (MIS) versus open surgical approach. 13 However, results regarding LOS and spine surgery have predominantly been those of incidence; an analysis evaluating length of stay as an isolated outcome measure is lacking.…”

mentioning

confidence: 99%

Predicting Extended Length of Hospital Stay in an Adult Spinal Deformity Surgical Population

Klineberg¹,

Passias²,

Jalai³

et al. 2016

Spine

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“…2–5 Several studies have demonstrated an increase in lumbar surgical intervention (decompression and/or fusion) in the broadly termed elderly population over the past 20 years. 2,3,6–8 Other studies have investigated safety and efficacy of lumbar spine surgery in this age group, with results showing both benefits 9–13 and risks. 14 However, no prior study has specifically identified national trends in the use of lumbar fusion surgery for the octogenarian population, with respect to demographics, discharge time, and economic impact.…”

Section: Introductionmentioning

confidence: 99%

Trends in Lumbar Fusion Surgery Among Octogenarians: A Nationwide Inpatient Sample Study From 2004 to 2013

Kha

Ilyas

Tanenbaum

et al. 2018

Global Spine Journal

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Study Design:Retrospective analysis.Objectives:Given the aging US population and natural degenerative process of the spine, more elderly patients with lumbar spinal disease are surgical candidates. Prior studies have assessed safety and efficacy of lumbar fusion (LF) surgeries in the elderly, but none have reviewed fusion procedures from an epidemiological standpoint. Here, we report 2004-2013 national trends in demographics, discharge time, and economic impact of LF procedures for octogenarians.Methods:The Nationwide Inpatient Sample database was queried from 2004 to 2013 for LF procedures in patients aged 80 to 89 years. Patients were grouped by fusion level, demographics, comorbidity score, insurance, and hospital characteristics. Postoperative variables include length of stay and total in-hospital charges. Data was evaluated using chi-squared tests and t tests.Results:The national sample included 17 471 LF procedures (mean age = 82.65 years). From 2004 to 2013, the annual number of LF procedures increased from 1144 to 2061 patients. Percentage of multilevel LF was relatively maintained (mean = 18%). The majority of patients were female (mean = 62%). The proportion of males increased during the study period (31.8% to 42.5%; P < .0001). The proportion of patients with a comorbidity score of 2 or 3 increased during the study period (P < .0001). Over time, average length of stay decreased (from 6 to 4.5 days; P < .0001), and total in-hospital charges increased (from $58 471 to $111 235; P < .0001).Conclusions:These results suggest that more lumbar fusion procedures are being performed on octogenarians in recent years. While these patients are discharged from hospitals more quickly after surgery, there is also greater financial burden placed on patients, hospitals, and society.

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Clinical Outcomes of Discectomy in Octogenarian Patients With Lumbar Disc Herniation

Cited by 30 publications

References 17 publications

Using the ACS-NSQIP to Identify Factors Affecting Hospital Length of Stay After Elective Posterior Lumbar Fusion

Using the ACS-NSQIP to Identify Factors Affecting Hospital Length of Stay After Elective Posterior Lumbar Fusion

Predicting Extended Length of Hospital Stay in an Adult Spinal Deformity Surgical Population

Trends in Lumbar Fusion Surgery Among Octogenarians: A Nationwide Inpatient Sample Study From 2004 to 2013

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