Introduction
Age has been shown to increase risk of postoperative complications. The current study is the largest known study of postoperative complications after spine surgery by age cohort, using the National Surgical Quality Improvement Program (NSQIP) database.
Methods
A retrospective analysis NSQIP data of 46,509 patients undergoing spine surgery from 2005 to 2014 was performed using specific Current Procedural Terminology (CPT) codes. 30-day postoperative data was collected, analyzed, and broken into age cohorts \u3c30, 30-39, 40-49, 50-59, 60-69, 70-79, and 80-89, to determine differences in complications by age group.
Results
46,509 patients were analyzed. Age was a significant predictor of deep surgical site infection, reoperation rate, pneumonia, pulmonary embolism, unplanned intubation, urinary tract infection, requiring postoperative transfusion, postoperative myocardial infarction, cardiac arrest requiring resuscitation, and DVT. Older patients also had longer overall hospital stays and higher rates of hospital readmission. There was no difference in the rate of superficial SSI based on age groups and the highest rate of wound disruption was found in the \u3c30 age group.
Discussion
Age is a significant predictor of most 30-day postoperative complications after spine surgery. Higher rates of complications in older age cohorts, as well as increased length of stay and higher readmission rates, suggest the need for individualized counseling and decision-making around spine surgery in the elderly
