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Retrospective, propensity score-matched cohort study examining timing of fracture fixation for traumatic thoracolumbar fractures.

Publication ,  Journal Article
Boakye, M; Arrigo, RT; Hayden Gephart, MG; Zygourakis, CC; Lad, S
Published in: J Neurotrauma
August 10, 2012

The timing of surgery in patients with traumatic thoracic/thoracolumbar fractures, with or without spinal cord injury, remains controversial. The objective of this study was to determine the importance of the timing of surgery for complications and resource utilization following fixation of traumatic thoracic/thoracolumbar fractures. In this retrospective cohort study, the 2003-2008 California Inpatient Databases were searched for patients receiving traumatic thoracic/thoracolumbar fracture fixation. Patients were classified as having early (<72 h) or late (>72 h) surgery. Propensity score modeling produced a matched cohort balanced on age, comorbidity, trauma severity, and other factors. Complications, mortality, length of stay, and hospital charges were assessed. Multivariate logistic regression was used to determine the impact of delayed surgery on in-hospital complications after balancing and controlling for other important factors. Early surgery (<72 h) for traumatic thoracic/thoracolumbar fractures was associated with a significantly lower overall complication rate (including cardiac, thromboembolic, and respiratory complications), and decreased hospital stay. In-hospital charges were significantly lower ($38,120 difference) in the early surgery group. Multivariate analysis identified time to surgery as the strongest predictor of in-hospital complications, although age, medical comorbidities, and injury severity score were also independently associated with increased complications. We reinforce the beneficial impact of early spinal surgery (prior to 72 h) in traumatic thoracic/thoracolumbar fractures to reduce in-hospital complications, hospital stay, and resource utilization. These results provide further support to the emerging literature and professional consensus regarding the importance of early thoracic/thoracolumbar spine stabilization of traumatic fractures to improve patient outcomes and limit hospitalization costs.

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Published In

J Neurotrauma

DOI

EISSN

1557-9042

Publication Date

August 10, 2012

Volume

29

Issue

12

Start / End Page

2220 / 2225

Location

United States

Related Subject Headings

  • Young Adult
  • Treatment Outcome
  • Time Factors
  • Thoracic Vertebrae
  • Spinal Fusion
  • Spinal Fractures
  • Retrospective Studies
  • Neurology & Neurosurgery
  • Multivariate Analysis
  • Middle Aged
 

Citation

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Boakye, M., Arrigo, R. T., Hayden Gephart, M. G., Zygourakis, C. C., & Lad, S. (2012). Retrospective, propensity score-matched cohort study examining timing of fracture fixation for traumatic thoracolumbar fractures. J Neurotrauma, 29(12), 2220–2225. https://doi.org/10.1089/neu.2012.2364
Boakye, Maxwell, Robert T. Arrigo, Melanie G. Hayden Gephart, Corinna C. Zygourakis, and Shivanand Lad. “Retrospective, propensity score-matched cohort study examining timing of fracture fixation for traumatic thoracolumbar fractures.J Neurotrauma 29, no. 12 (August 10, 2012): 2220–25. https://doi.org/10.1089/neu.2012.2364.
Boakye M, Arrigo RT, Hayden Gephart MG, Zygourakis CC, Lad S. Retrospective, propensity score-matched cohort study examining timing of fracture fixation for traumatic thoracolumbar fractures. J Neurotrauma. 2012 Aug 10;29(12):2220–5.
Boakye, Maxwell, et al. “Retrospective, propensity score-matched cohort study examining timing of fracture fixation for traumatic thoracolumbar fractures.J Neurotrauma, vol. 29, no. 12, Aug. 2012, pp. 2220–25. Pubmed, doi:10.1089/neu.2012.2364.
Boakye M, Arrigo RT, Hayden Gephart MG, Zygourakis CC, Lad S. Retrospective, propensity score-matched cohort study examining timing of fracture fixation for traumatic thoracolumbar fractures. J Neurotrauma. 2012 Aug 10;29(12):2220–2225.
Journal cover image

Published In

J Neurotrauma

DOI

EISSN

1557-9042

Publication Date

August 10, 2012

Volume

29

Issue

12

Start / End Page

2220 / 2225

Location

United States

Related Subject Headings

  • Young Adult
  • Treatment Outcome
  • Time Factors
  • Thoracic Vertebrae
  • Spinal Fusion
  • Spinal Fractures
  • Retrospective Studies
  • Neurology & Neurosurgery
  • Multivariate Analysis
  • Middle Aged