• World Neurosurg · Jul 2017

    Comparative Study

    Spine Surgery Outcomes in the Elderly versus the General Adult Patient Population in the United States: A MarketScan Analysis.

    • Carlito Lagman, Beatrice Ugiliweneza, Maxwell Boakye, and Doniel Drazin.
    • Department of Neurosurgery, Cedars-Sinai Medical Center, Los Angeles, California, USA.
    • World Neurosurg. 2017 Jul 1; 103: 780-788.

    ObjectiveTo compare spine surgery outcomes in elderly patients (80-103 years old) versus general adult patients (18-79 years-old) in the United States.MethodsTruven Health Analytics MarketScan Research Databases (2000-2012) were queried. Patients with a diagnosis of degenerative disease of the spine without concurrent spinal stenosis, spinal stenosis without concurrent degenerative disease, or degenerative disease with concurrent spinal stenosis and who had undergone decompression without fusion, fusion without decompression, or decompression with fusion procedures were included. Indirect outcome measures included length of stay, in-hospital mortality, in-hospital and 30-day complications, and discharge disposition.ResultsPatients (N = 155,720) were divided into elderly (n = 10,232; 6.57%) and general adult (n = 145,488; 93.4%) populations. Mean length of stay was longer in elderly patients versus general adult patients (3.62 days vs. 3.11 days; P < 0.0001). In-hospital mortality was more common in elderly patients versus general adult patients (0.31% vs. 0.06%; P < 0.0001). In-hospital and 30-day complications were more common in elderly patients versus general adult patients (11.3% vs. 7.15% and 17.8% vs. 12.6%; P < 0.0001). Nonroutine discharge was more common in elderly patients versus general adult patients (33.7% vs. 16.2%; P < 0.0001).ConclusionsOur results revealed significantly longer hospital stays, more in-hospital mortalities, and more in-hospital and 30-day complications after decompression without fusion, fusion without decompression, or decompression with fusion procedures in elderly patients.Copyright © 2017 Elsevier Inc. All rights reserved.

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