Can Elective Spine Surgery Be Performed Safely Among Nonagenarians?: Analysis of a National Inpatient Database in Japan

Study Design. Retrospective cohort study. Objective. To compare morbidity and mortality between nonagenarians and other older adult patients who underwent elective spine surgery. Summary of Background Data. There is a lack of information of the perioperative risks of nonagenarians undergoing spine surgery. Methods. Data of patients aged ≥65 years who underwent elective spine surgery from July 2010 to March 2013 were extracted from the Diagnosis Procedure Combination database, a nationwide administrative inpatient database in Japan. Clinical outcomes included mortality, occurrence of major complications (cardiac events, respiratory complications, pulmonary embolism, stroke, and acute renal failure), urinary tract infection, and postoperative delirium. These clinical outcomes in nonagenarians were compared with those in patients aged 65 to 79 years and octogenarians. A multivariate logistic regression model fitted with a generalized estimation equation was used to evaluate the influence of advanced age on 90-day mortality and postoperative major complications. Results. Of 88,370 patients identified in the database, 418 were nonagenarians. Compared with patients aged 65 to 79 years and octogenarians, nonagenarians had the highest rates of 90-day mortality (0.2%, 0.3%, and 1.7%, respectively; P 
Source: Spine - Category: Orthopaedics Tags: CLINICAL CASE SERIES Source Type: research