• World Neurosurg · May 2019

    Risk Factors Associated with 30-Day Mortality Following Open Reduction and Internal Fixation of Vertebral Fractures.

    • Ivan B Ye, Steven J Girdler, Zoe B Cheung, Samuel J White, William A Ranson, and Samuel Kang-Wook Cho.
    • Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
    • World Neurosurg. 2019 May 1; 125: e1069-e1073.

    ObjectiveFew studies have examined the outcomes of open reduction and internal fixation of vertebral fractures. The purpose of this study was to determine patient-related and surgery-related risk factors associated with 30-day postoperative mortality after open reduction and internal fixation (ORIF) of cervical, thoracic, and lumbar vertebral fractures.MethodsThis was a retrospective cohort study of data from the 2010-2014 ACS-NSQIP database. Adult patients who underwent ORIF of vertebral fractures in the cervical, thoracic, or lumbar spine were included. Patients were divided into 2 groups on the basis of the occurrence of 30-day postoperative mortality. A univariate analysis was performed to compare baseline patient characteristics, comorbidities, operative variables, and 30-day postoperative complications between the mortality and nonmortality groups. A subsequent multivariate regression analysis adjusting for patient and operative factors was then performed to identify independent risk factors for 30-day mortality.ResultsA total of 900 patients who underwent vertebral ORIF were included. The overall 30-day postoperative mortality rate was 1.56%. The mortality group had a higher incidence of pneumonia, pulmonary complications, cardiac complications, blood transfusion, sepsis, and prolonged hospitalization. Multivariate regression analysis identified pulmonary comorbidity and diabetes as independent predictors of 30-day mortality following ORIF of vertebral fractures.ConclusionsPulmonary comorbidity and diabetes were found to be independent risk factors for 30-day mortality after ORIF of vertebral fractures. Recognizing these risk factors is important in preoperative risk stratification, perioperative care, and patient counseling.Copyright © 2019 Elsevier Inc. All rights reserved.

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