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Impact of Chronic Obstructive Pulmonary Disease on Postoperative Complication Rates, Ambulation, and Length of Hospital Stay After Elective Spinal Fusion (≥3 Levels) in Elderly Spine Deformity Patients.

Publication ,  Journal Article
Elsamadicy, AA; Sergesketter, AR; Kemeny, H; Adogwa, O; Tarnasky, A; Charalambous, L; Lubkin, DET; Davison, MA; Cheng, J; Bagley, CA; Karikari, IO
Published in: World neurosurgery
August 2018

To investigate the impact that chronic obstructive pulmonary disease (COPD) has on postoperative complication rates, ambulation, and hospital length of stay for elderly spinal deformity patients after elective spinal fusion (≥3 levels).The medical records of 559 elderly (≥60 years old) spine deformity patients undergoing elective spinal fusion (≥3 levels) at a major academic institution from 2005 to 2015 were reviewed. We identified 60 patients with COPD (10.7%) and 499 patients without COPD (89.3%). Patient demographics, comorbidities, postoperative complications, ambulatory status, and readmission rates were collected. The primary outcomes investigated in this study were complication rates and length of hospital stay.Demographics and comorbidities were similar between groups, with a difference in proportion of smokers (COPD group: 25.0% vs. no COPD group: 9.6%, P = 0.0004). The median number of fusion levels (P = 0.840), operative time (P = 0.842), estimated blood loss (P = 0.336), and incidences of durotomy (P = 0.258) was similar between both cohorts. The COPD cohort experienced a higher rate of postoperative fever (10.0% vs. 3.0%, P = 0.007) and pneumonia (5.0% vs. 0.4%, P = 0.0004), respectively. There was a significant difference in the number of feet walked on the first day of ambulation after surgery (COPD group: 58.6 ± 78.4 vs. no COPD group: 84.0 ± 102.8, P = 0.040). Length of hospital stay was significantly longer in the COPD cohort than the no COPD cohort (7.7 ± 6.4 vs. 6.0 ± 4.0 days, respectively; P = 0.0498).Our study demonstrates that elderly patients with COPD have increased lengths of stay and higher rates of postoperative pneumonia after spinal fusion. This determination identifies a potentially modifiable risk factor for increased utilization of health care resources.

Duke Scholars

Published In

World neurosurgery

DOI

EISSN

1878-8769

ISSN

1878-8750

Publication Date

August 2018

Volume

116

Start / End Page

e1122 / e1128

Related Subject Headings

  • Walking
  • Spinal Fusion
  • Spinal Diseases
  • Risk Factors
  • Retrospective Studies
  • Pulmonary Disease, Chronic Obstructive
  • Postoperative Complications
  • Patient Readmission
  • Middle Aged
  • Male
 

Citation

APA
Chicago
ICMJE
MLA
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Elsamadicy, A. A., Sergesketter, A. R., Kemeny, H., Adogwa, O., Tarnasky, A., Charalambous, L., … Karikari, I. O. (2018). Impact of Chronic Obstructive Pulmonary Disease on Postoperative Complication Rates, Ambulation, and Length of Hospital Stay After Elective Spinal Fusion (≥3 Levels) in Elderly Spine Deformity Patients. World Neurosurgery, 116, e1122–e1128. https://doi.org/10.1016/j.wneu.2018.05.185
Elsamadicy, Aladine A., Amanda R. Sergesketter, Hanna Kemeny, Owoicho Adogwa, Aaron Tarnasky, Lefko Charalambous, David E. T. Lubkin, et al. “Impact of Chronic Obstructive Pulmonary Disease on Postoperative Complication Rates, Ambulation, and Length of Hospital Stay After Elective Spinal Fusion (≥3 Levels) in Elderly Spine Deformity Patients.World Neurosurgery 116 (August 2018): e1122–28. https://doi.org/10.1016/j.wneu.2018.05.185.
Elsamadicy AA, Sergesketter AR, Kemeny H, Adogwa O, Tarnasky A, Charalambous L, Lubkin DET, Davison MA, Cheng J, Bagley CA, Karikari IO. Impact of Chronic Obstructive Pulmonary Disease on Postoperative Complication Rates, Ambulation, and Length of Hospital Stay After Elective Spinal Fusion (≥3 Levels) in Elderly Spine Deformity Patients. World neurosurgery. 2018 Aug;116:e1122–e1128.
Journal cover image

Published In

World neurosurgery

DOI

EISSN

1878-8769

ISSN

1878-8750

Publication Date

August 2018

Volume

116

Start / End Page

e1122 / e1128

Related Subject Headings

  • Walking
  • Spinal Fusion
  • Spinal Diseases
  • Risk Factors
  • Retrospective Studies
  • Pulmonary Disease, Chronic Obstructive
  • Postoperative Complications
  • Patient Readmission
  • Middle Aged
  • Male