• Jason O Toy, Bryce A Basques, and Jonathan N Grauer.
• From the Department of Orthopaedics and Rehabilitation, Yale University School of Medicine, New Haven, CT.
• Spine. 2014 Nov 1;39(23):1943-9.

Study DesignRetrospective cohort study.ObjectiveTo identify risk factors for poor short-term outcomes after vertebral augmentation procedures.Summary Of Background DataVertebral compression fractures are the most common fractures of osteoporosis and are frequently treated with vertebroplasty or kyphoplasty. There is a shortage of information about risk factors for short-term, general health outcomes after vertebral augmentation in the literature.MethodsPatients older than 65 years who underwent vertebroplasty or kyphoplasty in 2011 and 2012 were identified from the American College of Surgeons National Surgical Quality Improvement Program database. Patient characteristics were tested for association with 30-day adverse events, mortality, and readmission using bivariate and multivariate analyses.ResultsA total of 850 patients met inclusion criteria. The average age was 78.9±11.7 years (mean±standard deviation) and females made up 70.8% of the cohort. Of these patients, 9.5% had any adverse event (AAE), and 6.6% had a serious adverse event (SAE). Death occurred in 1.5% of patients, and 10.8% were readmitted within the first 30 postoperative days.On multivariate analysis, AAE and SAE were both significantly associated with American Society of Anesthesiologists class 4 (AAE: odds ratio [OR]=2.7, P=0.013; SAE: OR=2.5, P=0.040) and inpatient status before procedure (AAE: OR=2.7, P<0.001, SAE: OR=2.4, P=0.003). Increased postoperative mortality rate was associated with American Society of Anesthesiologists class 4 (OR=6.4, P=0.024) and the use of nongeneral anesthesia (OR=4.0, P=0.022). Readmission was associated with history of pulmonary disease (OR=2.0, P=0.005) and inpatient status before procedure (OR=1.9, P=0.005).ConclusionAdverse general health outcomes were relatively common, and the factors identified in the earlier text associated with patient outcomes after vertebral augmentation may be useful for preoperative discussions and counseling.Level Of Evidence3.

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