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Risk Factors ID'd for Post-Spine Surgery Death, Morbidity

Complication predictors include older age, cardiac disease, neuro-abnormalities, corticosteroid use

MONDAY, Oct. 3 (HealthDay News) -- Older age, wound infections, and other medical comorbidities increase the risk of immediate morbidity or mortality in patients undergoing spine surgery, according to a study published in the Sept. 7 issue of The Journal of Bone & Joint Surgery.

Andrew J. Schoenfeld, M.D., from the William Beaumont Army Medical Center in El Paso, Texas, and colleagues identified risk factors for immediate postoperative morbidity and mortality in patients undergoing spine surgery. A total of 3,475 patients (average age, 55.5 years) undergoing spine surgery from 2005 to 2008 were identified from the National Surgical Quality Improvement Program, and data were collected on demographics, comorbidities, medical history, body mass index, and the type of procedure performed. Postoperative complications and mortality within 30 days after the spinal procedure were also identified. The effect of individual risk factors on mortality and the risk of postoperative complications were evaluated.

The investigators identified death and complications in 0.3 and 7.6 percent of the patients, respectively, after surgery. Independent predictors of death were increased patient age and contaminated or infected wounds. The development of one or more complications was predicted by increased patient age, cardiac disease, preoperative neurologic abnormalities, prior wound infection, corticosteroid use, history of sepsis, American Society of Anesthesiologists classification of greater than 2, and prolonged surgical times.

"The results of this study can potentially enhance patient care and safety by informing preoperative discussions, patient selection, and medical optimization in the preoperative and perioperative periods," the authors write.

One or more of the study authors disclosed financial ties to the biomedical industry.

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