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In-hospital medical complications after non-operative and operative treatment of thoracolumbar fractures in patients over 75 years of age.

Publication ,  Journal Article
Purvis, TE; De la Garza Ramos, R; Sankey, EW; Karikari, IO; Goodwin, CR; Sciubba, DM
Published in: J Clin Neurosci
April 2018

Management of spine fractures among the elderly is complicated by preexisting comorbidities and increased risk of osseous nonunion. Whether operative treatment is superior for the management of thoracolumbar fractures in the aged is unknown. The purpose of this study was to investigate the rates of in-hospital medical complications after non-operative and operative treatment of thoracolumbar fractures in elderly patients. The Nationwide Inpatient Sample database from 2002 to 2011 was used to identify patients over 75 years of age with a principal discharge diagnosis of thoracolumbar fracture without spinal cord injury. Three treatment groups were compared: non-operative treatment, operative treatment, and minimally-invasive vertebroplasty/kyphoplasty (VP/KP). A total of 59,565 patients were identified; 46,962 treated non-operatively, 1,487 treated operatively, and 11,116 treated with VP/KP. Operative patients had the longest length of hospital stay (P < 0.001) and the highest injury severity scores (P < 0.001). The percentage of patients who developed at least one complication was highest in the operative group (16.3%), versus 8.7% in the non-operative and 8.1% in the VP/KP group (P < 0.001). Even after controlling for potential confounders such as injury severity score, surgical patients had significantly higher odds of complication occurrence (P < 0.001). Adjusted charges were highest for operative patients ($123,777 ± 135,997 vs. $27,116 ± 32,694 [non-operative] and $42,326 ± 31,984 [VP/KP]). Operative treatment for elderly patients has higher complication rates that need to be considered during preoperative patient counseling. Future research is necessary to elucidate the comparative rates of long-term complications and functional status outcomes for thoracolumbar fracture treatment among elderly patients.

Duke Scholars

Published In

J Clin Neurosci

DOI

EISSN

1532-2653

Publication Date

April 2018

Volume

50

Start / End Page

83 / 87

Location

Scotland

Related Subject Headings

  • Thoracic Vertebrae
  • Spinal Fractures
  • Retrospective Studies
  • Postoperative Complications
  • Patient Discharge
  • Orthopedic Procedures
  • Neurology & Neurosurgery
  • Male
  • Lumbar Vertebrae
  • Length of Stay
 

Citation

APA
Chicago
ICMJE
MLA
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Purvis, T. E., De la Garza Ramos, R., Sankey, E. W., Karikari, I. O., Goodwin, C. R., & Sciubba, D. M. (2018). In-hospital medical complications after non-operative and operative treatment of thoracolumbar fractures in patients over 75 years of age. J Clin Neurosci, 50, 83–87. https://doi.org/10.1016/j.jocn.2018.01.061
Purvis, Taylor E., Rafael De la Garza Ramos, Eric W. Sankey, Isaac O. Karikari, C Rory Goodwin, and Daniel M. Sciubba. “In-hospital medical complications after non-operative and operative treatment of thoracolumbar fractures in patients over 75 years of age.J Clin Neurosci 50 (April 2018): 83–87. https://doi.org/10.1016/j.jocn.2018.01.061.
Purvis TE, De la Garza Ramos R, Sankey EW, Karikari IO, Goodwin CR, Sciubba DM. In-hospital medical complications after non-operative and operative treatment of thoracolumbar fractures in patients over 75 years of age. J Clin Neurosci. 2018 Apr;50:83–7.
Purvis, Taylor E., et al. “In-hospital medical complications after non-operative and operative treatment of thoracolumbar fractures in patients over 75 years of age.J Clin Neurosci, vol. 50, Apr. 2018, pp. 83–87. Pubmed, doi:10.1016/j.jocn.2018.01.061.
Purvis TE, De la Garza Ramos R, Sankey EW, Karikari IO, Goodwin CR, Sciubba DM. In-hospital medical complications after non-operative and operative treatment of thoracolumbar fractures in patients over 75 years of age. J Clin Neurosci. 2018 Apr;50:83–87.
Journal cover image

Published In

J Clin Neurosci

DOI

EISSN

1532-2653

Publication Date

April 2018

Volume

50

Start / End Page

83 / 87

Location

Scotland

Related Subject Headings

  • Thoracic Vertebrae
  • Spinal Fractures
  • Retrospective Studies
  • Postoperative Complications
  • Patient Discharge
  • Orthopedic Procedures
  • Neurology & Neurosurgery
  • Male
  • Lumbar Vertebrae
  • Length of Stay