Scoliosis surgery in the elderly: Complications, readmissions, reoperations and mortality.
The operative management of scoliosis in the elderly remains controversial. The authors of this study sought to evaluate outcomes in elderly patients with scoliosis undergoing deformity correction. Patient data was obtained from a 5% sample of the Medicare Provided Analysis and Review database (MEDPAR). Patients over 65years of age with scoliosis undergoing corrective surgery were identified between the years 2005 to 2011. A total of 453 patients were analyzed: 262 (57%) between ages 66 to 74years, and 191 (42%) over the age of 75years. Female predominance (78%) was observed in this sample. Pre-diagnosis follow-up averaged 118months. Post-surgery follow-up averaged 33months. Patients between 66 and 74years old were mostly discharged home, while patients over the age of 75years were discharged to skilled nursing facilities (SNFs) (38.55% versus 34.04%, p value=0.0011). Readmission rates were lower in patients between 66 and 74years old when compared to patients over the age of 75years (9.92% versus 17.28%, p value=0.0217). Complication rates 30-days after discharge were less in patients between 66 and 74years, compared to those over 75years (21% versus 26.6%, respectively), but this was not statistically significant. These findings suggest varying outcomes following scoliosis surgery in the elderly, but interpretation of these results is weakened by the inherent limitations of database utilization. Future prospective studies are needed to understand risk factors and other confounding variables, such as discharge disposition, that may influence outcomes.
Department of Neurosurgery, Cedars-Sinai Medical Center, 127 S. San Vicente Blvd, Los Angeles, CA 90048, USA. Electronic address: Doniel.drazin@cshs.org.
Doniel
D
Drazin
Department of Neurosurgery, Cedars-Sinai Medical Center, 127 S. San Vicente Blvd, Los Angeles, CA 90048, USA.
Lutfi
L
Al-Khouja
Department of Neurosurgery, Cedars-Sinai Medical Center, 127 S. San Vicente Blvd, Los Angeles, CA 90048, USA.
Carlito
C
Lagman
Department of Neurosurgery, University of Louisville, Louisville, KY, USA.
Beatrice
B
Ugiliweneza
Department of Neurosurgery, Cedars-Sinai Medical Center, 127 S. San Vicente Blvd, Los Angeles, CA 90048, USA.
Faris
F
Shweikeh
Department of Neurosurgery, Cedars-Sinai Medical Center, 127 S. San Vicente Blvd, Los Angeles, CA 90048, USA.
J Patrick
JP
Johnson
Department of Orthopedics, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Terrence T
TT
Kim
Department of Neurosurgery, University of Louisville, Louisville, KY, USA.
Maxwell
M
Boakye
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D016208:Databases, Factual; D005260:Female; D006801:Humans; D008297:Male; D019635:Neurosurgical Procedures / Q000009:adverse effects / Q000401:mortality / Q000706:statistics & numerical data*; D010359:Patient Readmission / Q000706:statistics & numerical data; D011183:Postoperative Complications / Q000453:epidemiology; D012086:Reoperation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012600:Scoliosis / Q000401:mortality / Q000601:surgery*; D016896:Treatment Outcome
Elderly; Outcomes Scoliosis; Spine surgery