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16.10.2021 | Original Article

The impact of osteoporosis on adult deformity surgery outcomes in Medicare patients

verfasst von: Kunal Varshneya, Anika Bhattacharjya, Rayyan T. Jokhai, Parastou Fatemi, Zachary A. Medress, Martin N. Stienen, Allen L. Ho, John K. Ratliff, Anand Veeravagu

Erschienen in: European Spine Journal | Ausgabe 1/2022

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Abstract

Objective

To identify the impact of osteoporosis (OS) on postoperative outcomes in Medicare patients undergoing ASD surgery.

Background

Patients with OP and advanced age experience higher than average rates of ASD. However, poor bone density could undermine the durability of a deformity correction.

Methods

We queried the MarketScan Medicare Supplemental database to identify patients Medicare patients who underwent ASD surgery from 2007 to 2016.

Results

A total of 2564 patients met the inclusion criteria of this study, of whom n = 971 (61.0%) were diagnosed with osteoporosis. Patients with OP had a similar 90-day postoperative complication rates (OP: 54.6% vs. non-OP: 49.2%, p = 0.0076, not significant after multivariate regression correction). This was primarily driven by posthemorrhagic anemia (37.6% in OP, vs. 33.1% in non-OP). Rates of revision surgery were similar at 90 days (non-OP 15.0%, OP 16.8%), but by 2 years, OP patients had a significantly higher reoperation rate (30.4% vs. 22.9%, p < 0.0001). In multivariate regression analysis, OP increased odds for revision surgery at 1 year (OR 1.4) and 2 years (OR 1.5) following surgery (all p < 0.05). OP was also an independent predictor of readmission at all time points (90 days, OR 1.3, p < 0.005).

Conclusion

Medicare patients with OP had elevated rates of complications, reoperations, and outpatient costs after undergoing primary ASD surgery.

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Titel: The impact of osteoporosis on adult deformity surgery outcomes in Medicare patients
verfasst von: Kunal Varshneya
Anika Bhattacharjya
Rayyan T. Jokhai
Parastou Fatemi
Zachary A. Medress
Martin N. Stienen
Allen L. Ho
John K. Ratliff
Anand Veeravagu
Publikationsdatum: 16.10.2021
Verlag: Springer Berlin Heidelberg
Erschienen in: European Spine Journal / Ausgabe 1/2022
Print ISSN: 0940-6719
Elektronische ISSN: 1432-0932
DOI: https://doi.org/10.1007/s00586-021-06985-z

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The impact of osteoporosis on adult deformity surgery outcomes in Medicare patients