Background
Methods
Data source
Patients
Outcomes
Statistical analysis
Results
Overall | Cervical laminoplasty | Lumbar decompression | Lumbar arthrodesis | Total knee arthroplasty | p | |
---|---|---|---|---|---|---|
(n = 107,104) | (n = 16,020) | (n = 31,605) | (n = 18,419) | (n = 41,060) | ||
Age, years; mean [SD] | 70.1 [10.7] | 66.2 [11.6] | 68.9 [11.3] | 65.7 [12.1] | 74.6 [6.9] | < 0.001 |
≤ 64 | 25,927 (24.2) | 6,534 (40.8) | 8,898 (28.2) | 6,976 (37.9) | 3,519 (8.6) | |
65–79 | 63,838 (59.0) | 7,678 (47.9) | 18,166 (57.5) | 10,060 (54.6) | 27,394 (68.0) | |
≥ 80 | 17,339 (16.2) | 1,808 (11.3) | 4,541 (14.4) | 1,383 (7.5) | 9,607 (23.4) | |
Sex
| ||||||
Men | 45,044 (42.1) | 11,050 (69.0) | 18,735 (59.3) | 8,456 (45.9) | 6,803 (16.6) | < 0.001 |
Women | 62,060 (57.9) | 4,970 (31.0) | 12,870 (40.7) | 9,963 (54.1) | 34,257 (83.4) | |
Charlson comorbidity index
| ||||||
0 | 68,931 (64.4) | 9,518 (59.4) | 20,234(64.0) | 11,971 (65.0) | 27,208 (66.3) | < 0.001 |
1 | 24,068 (22.5) | 3,481 (21.7) | 7,060(22.3) | 3,825 (20.8) | 9,702 (23.6) | |
2 | 9,656 (9.0) | 1,885 (11.8) | 2,928(9.3) | 1,747 (9.5) | 3,096 (7.5) | |
≥ 3 | 4,449 (4.2) | 1,136 (7.1) | 1,383(4.4) | 876 (4.8) | 1,054 (2.6) | |
Postoperative length of stay, day, median [IQR] | 21 [15–30] | 18 [14–26] | 20 [15–28] | 27 [21–36] | < 0.001 |
Cervical laminoplasty | Lumbar decompression | Lumbar arthrodesis | Total knee arthroplasty | p | |
---|---|---|---|---|---|
(n = 16,020) | (n = 31,605) | (n =18,419) | (n = 41,060) | ||
Inhospital death, n (%)
| 32 (0.20) | 35 (0.11) | 27 (0.15) | 27 (0.066) | < 0.001 |
Age ≤ 64 years | 5(0.077) | 4 (0.045) | 3 (0.043) | 1 (0.028) | |
65–79 | 17(0.22) | 20 (0.11) | 17 (0.17) | 15 (0.055) | |
≥ 80 | 10(0.55) | 11 (0.24) | 7 (0.51) | 11 (0.11) | |
Postoperative complications, n (%)
| |||||
Surgical site infection | 320 (2.0) | 511 (1.6) | 362 (2.0) | 636 (1.5) | < 0.001 |
Sepsis | 25 (0.16) | 53 (0.17) | 53 (0.29) | 61 (0.15) | 0.002 |
Cardiac events | 279 (1.7) | 508 (1.6) | 302 (1.6) | 677 (1.6) | 0.754 |
Respiratory complications | 96 (0.60) | 104 (0.33) | 88 (0.48) | 196 (0.48) | < 0.001 |
Pulmonary embolism | 16 (0.10) | 31 (0.10) | 31 (0.17) | 167 (0.41) | < 0.001 |
Stroke | 71 (0.44) | 74 (0.23) | 42 (0.23) | 92 (0.22) | < 0.001 |
Acute renal failure | 1 (0.006) | 8 (0.025) | 7 (0.038) | 15 (0.037) | 0.227 |
At least one complication, n (%)
| 757 (4.7) | 1,197 (3.8) | 808 (4.4) | 1,686 (4.1) | < 0.001 |
Age ≤ 64 years | 264 (4.0) | 254 (2.9) | 248 (3.6) | 106 (3.0) | |
65–79 | 384 (5.0) | 716 (3.9) | 467 (4.6) | 1,114 (4.1) | |
≥ 80 | 109 (6.0) | 227 (5.0) | 93 (6.7) | 466 (4.9) |
Inhospital death | Postoperative complications | |||||||
---|---|---|---|---|---|---|---|---|
OR | 95% CI | p | OR | 95% CI | p | |||
Age
| ||||||||
≤ 64 | Reference | Reference | ||||||
65–79 | 2.58 | 1.36 – 4.89 | 0.004 | 1.22 | 1.09 – 1.36 | 0.001 | ||
≥ 80 | 5.88 | 2.93 – 11.8 | <0.001 | 1.51 | 1.31 – 1.75 | < 0.001 | ||
Sex
| ||||||||
men | Reference | Reference | ||||||
women | 0.60 | 0.39 – 0.92 | 0.018 | 0.88 | 0.82 – 0.95 | 0.001 | ||
Charlson comorbidity index
| ||||||||
0 | Reference | Reference | ||||||
1 | 1.60 | 0.89 – 2.87 | 0.116 | 2.42 | 2.17 – 2.71 | < 0.001 | ||
2 | 6.58 | 3.99 – 10.8 | <0.001 | 3.42 | 2.92 – 4.01 | < 0.001 | ||
≥ 3 | 16.50 | 10 – 27.2 | <0.001 | 5.06 | 4.2 – 6.1 | < 0.001 | ||
Surgical procedure
| ||||||||
Total knee arthroplasty | Reference | Reference | ||||||
Cervical laminoplasty | 2.15 | 1.23 – 3.77 | 0.008 | 1.02 | 0.81 – 1.28 | 0.865 | ||
Lumbar decompression | 1.38 | 0.79 – 2.4 | 0.253 | 0.87 | 0.72 – 1.04 | 0.117 | ||
Lumbar arthrodesis | 2.23 | 1.21 – 4.06 | 0.009 | 1.07 | 0.92 – 1.24 | 0.397 |