Complications Associated With Spine Surgery in Patients Aged 80 Years or Older

Japan Association of Spine Surgeons with Ambition (JASA) Multicenter Study

Kazuyoshi Kobayashi, Shiro Imagama, Kei Ando, Naoki Ishiguro, Masaomi Yamashita, Yawara Eguchi, Morio Matsumoto, Ken Ishii, Tomohiro Hikata, Shoji Seki, Hidetomi Terai, Akinobu Suzuki, Koji Tamai, Masaaki Aramomi, Tetsuhiro Ishikawa, Atsushi Kimura, Hirokazu Inoue, Gen Inoue, Masayuki Miyagi, Wataru Saito & 40 others Kei Yamada, Michio Hongo, Hirosuke Nishimura, Hidekazu Suzuki, Atsushi Nakano, Kazuyuki Watanabe, Hirotaka Chikuda, Junichi Ohya, Yasuchika Aoki, Masayuki Shimizu, Toshimasa Futatsugi, Keijiro Mukaiyama, Masaichi Hasegawa, Katsuhito Kiyasu, Haku Iizuka, Yoichi Iizuka, Ryoichi Kobayashi, Kotaro Nishida, Kenichiro Kakutani, Hideaki Nakajima, Hideki Murakami, Satoru Demura, Satoshi Kato, Katsuhito Yoshioka, Takashi Namikawa, Kei Watanabe, Kazuyoshi Nakanishi, Yukihiro Nakagawa, Mitsunori Yoshimoto, Hiroyasu Fujiwara, Norihiro Nishida, Yasuaki Imajo, Masashi Yamazaki, Masataka Sakane, Tetsuya Abe, Kengo Fujii, Takashi Kaito, Takeo Furuya, Sumihisa Orita, Seiji Ohtori

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Study Design: Retrospective study of registry data. Objectives: Aging of society and recent advances in surgical techniques and general anesthesia have increased the demand for spinal surgery in elderly patients. Many complications have been described in elderly patients, but a multicenter study of perioperative complications in spinal surgery in patients aged 80 years or older has not been reported. Therefore, the goal of the study was to analyze complications associated with spine surgery in patients aged 80 years or older with cervical, thoracic, or lumbar lesions. Methods: A multicenter study was performed in patients aged 80 years or older who underwent 262 spinal surgeries at 35 facilities. The frequency and severity of complications were examined for perioperative complications, including intraoperative and postoperative complications, and for major postoperative complications that were potentially life threatening, required reoperation in the perioperative period, or left a permanent injury. Results: Perioperative complications occurred in 75 of the 262 surgeries (29%) and 33 were major complications (13%). In multivariate logistic regression, age over 85 years (hazard ratio [HR] = 1.007, P = 0.025) and estimated blood loss ≥500 g (HR = 3.076, P =.004) were significantly associated with perioperative complications, and an operative time ≥180 min (HR = 2.78, P =.007) was significantly associated with major complications. Conclusions: Elderly patients aged 80 years or older with comorbidities are at higher risk for complications. Increased surgical invasion, and particularly a long operative time, can cause serious complications that may be life threatening. Therefore, careful decisions are required with regard to the surgical indication and procedure in elderly patients.

Original languageEnglish
Pages (from-to)636-641
Number of pages6
JournalGlobal Spine Journal
Volume7
Issue number7
DOIs
Publication statusPublished - 2017 Oct 1

Fingerprint

Multicenter Studies
Japan
Spine
Operative Time
Perioperative Period
Intraoperative Complications
Surgeons
Reoperation
General Anesthesia
Registries
Comorbidity
Thorax
Retrospective Studies
Logistic Models
Wounds and Injuries

Keywords

  • complications
  • elderly
  • risk factor
  • spine surgery

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine
  • Clinical Neurology

Cite this

Complications Associated With Spine Surgery in Patients Aged 80 Years or Older : Japan Association of Spine Surgeons with Ambition (JASA) Multicenter Study. / Kobayashi, Kazuyoshi; Imagama, Shiro; Ando, Kei; Ishiguro, Naoki; Yamashita, Masaomi; Eguchi, Yawara; Matsumoto, Morio; Ishii, Ken; Hikata, Tomohiro; Seki, Shoji; Terai, Hidetomi; Suzuki, Akinobu; Tamai, Koji; Aramomi, Masaaki; Ishikawa, Tetsuhiro; Kimura, Atsushi; Inoue, Hirokazu; Inoue, Gen; Miyagi, Masayuki; Saito, Wataru; Yamada, Kei; Hongo, Michio; Nishimura, Hirosuke; Suzuki, Hidekazu; Nakano, Atsushi; Watanabe, Kazuyuki; Chikuda, Hirotaka; Ohya, Junichi; Aoki, Yasuchika; Shimizu, Masayuki; Futatsugi, Toshimasa; Mukaiyama, Keijiro; Hasegawa, Masaichi; Kiyasu, Katsuhito; Iizuka, Haku; Iizuka, Yoichi; Kobayashi, Ryoichi; Nishida, Kotaro; Kakutani, Kenichiro; Nakajima, Hideaki; Murakami, Hideki; Demura, Satoru; Kato, Satoshi; Yoshioka, Katsuhito; Namikawa, Takashi; Watanabe, Kei; Nakanishi, Kazuyoshi; Nakagawa, Yukihiro; Yoshimoto, Mitsunori; Fujiwara, Hiroyasu; Nishida, Norihiro; Imajo, Yasuaki; Yamazaki, Masashi; Sakane, Masataka; Abe, Tetsuya; Fujii, Kengo; Kaito, Takashi; Furuya, Takeo; Orita, Sumihisa; Ohtori, Seiji.

In: Global Spine Journal, Vol. 7, No. 7, 01.10.2017, p. 636-641.

Research output: Contribution to journalArticle

Kobayashi, K, Imagama, S, Ando, K, Ishiguro, N, Yamashita, M, Eguchi, Y, Matsumoto, M, Ishii, K, Hikata, T, Seki, S, Terai, H, Suzuki, A, Tamai, K, Aramomi, M, Ishikawa, T, Kimura, A, Inoue, H, Inoue, G, Miyagi, M, Saito, W, Yamada, K, Hongo, M, Nishimura, H, Suzuki, H, Nakano, A, Watanabe, K, Chikuda, H, Ohya, J, Aoki, Y, Shimizu, M, Futatsugi, T, Mukaiyama, K, Hasegawa, M, Kiyasu, K, Iizuka, H, Iizuka, Y, Kobayashi, R, Nishida, K, Kakutani, K, Nakajima, H, Murakami, H, Demura, S, Kato, S, Yoshioka, K, Namikawa, T, Watanabe, K, Nakanishi, K, Nakagawa, Y, Yoshimoto, M, Fujiwara, H, Nishida, N, Imajo, Y, Yamazaki, M, Sakane, M, Abe, T, Fujii, K, Kaito, T, Furuya, T, Orita, S & Ohtori, S 2017, 'Complications Associated With Spine Surgery in Patients Aged 80 Years or Older: Japan Association of Spine Surgeons with Ambition (JASA) Multicenter Study', Global Spine Journal, vol. 7, no. 7, pp. 636-641. https://doi.org/10.1177/2192568217716144
Kobayashi, Kazuyoshi ; Imagama, Shiro ; Ando, Kei ; Ishiguro, Naoki ; Yamashita, Masaomi ; Eguchi, Yawara ; Matsumoto, Morio ; Ishii, Ken ; Hikata, Tomohiro ; Seki, Shoji ; Terai, Hidetomi ; Suzuki, Akinobu ; Tamai, Koji ; Aramomi, Masaaki ; Ishikawa, Tetsuhiro ; Kimura, Atsushi ; Inoue, Hirokazu ; Inoue, Gen ; Miyagi, Masayuki ; Saito, Wataru ; Yamada, Kei ; Hongo, Michio ; Nishimura, Hirosuke ; Suzuki, Hidekazu ; Nakano, Atsushi ; Watanabe, Kazuyuki ; Chikuda, Hirotaka ; Ohya, Junichi ; Aoki, Yasuchika ; Shimizu, Masayuki ; Futatsugi, Toshimasa ; Mukaiyama, Keijiro ; Hasegawa, Masaichi ; Kiyasu, Katsuhito ; Iizuka, Haku ; Iizuka, Yoichi ; Kobayashi, Ryoichi ; Nishida, Kotaro ; Kakutani, Kenichiro ; Nakajima, Hideaki ; Murakami, Hideki ; Demura, Satoru ; Kato, Satoshi ; Yoshioka, Katsuhito ; Namikawa, Takashi ; Watanabe, Kei ; Nakanishi, Kazuyoshi ; Nakagawa, Yukihiro ; Yoshimoto, Mitsunori ; Fujiwara, Hiroyasu ; Nishida, Norihiro ; Imajo, Yasuaki ; Yamazaki, Masashi ; Sakane, Masataka ; Abe, Tetsuya ; Fujii, Kengo ; Kaito, Takashi ; Furuya, Takeo ; Orita, Sumihisa ; Ohtori, Seiji. / Complications Associated With Spine Surgery in Patients Aged 80 Years or Older : Japan Association of Spine Surgeons with Ambition (JASA) Multicenter Study. In: Global Spine Journal. 2017 ; Vol. 7, No. 7. pp. 636-641.
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abstract = "Study Design: Retrospective study of registry data. Objectives: Aging of society and recent advances in surgical techniques and general anesthesia have increased the demand for spinal surgery in elderly patients. Many complications have been described in elderly patients, but a multicenter study of perioperative complications in spinal surgery in patients aged 80 years or older has not been reported. Therefore, the goal of the study was to analyze complications associated with spine surgery in patients aged 80 years or older with cervical, thoracic, or lumbar lesions. Methods: A multicenter study was performed in patients aged 80 years or older who underwent 262 spinal surgeries at 35 facilities. The frequency and severity of complications were examined for perioperative complications, including intraoperative and postoperative complications, and for major postoperative complications that were potentially life threatening, required reoperation in the perioperative period, or left a permanent injury. Results: Perioperative complications occurred in 75 of the 262 surgeries (29{\%}) and 33 were major complications (13{\%}). In multivariate logistic regression, age over 85 years (hazard ratio [HR] = 1.007, P = 0.025) and estimated blood loss ≥500 g (HR = 3.076, P =.004) were significantly associated with perioperative complications, and an operative time ≥180 min (HR = 2.78, P =.007) was significantly associated with major complications. Conclusions: Elderly patients aged 80 years or older with comorbidities are at higher risk for complications. Increased surgical invasion, and particularly a long operative time, can cause serious complications that may be life threatening. Therefore, careful decisions are required with regard to the surgical indication and procedure in elderly patients.",
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T1 - Complications Associated With Spine Surgery in Patients Aged 80 Years or Older

T2 - Japan Association of Spine Surgeons with Ambition (JASA) Multicenter Study

AU - Kobayashi, Kazuyoshi

AU - Imagama, Shiro

AU - Ando, Kei

AU - Ishiguro, Naoki

AU - Yamashita, Masaomi

AU - Eguchi, Yawara

AU - Matsumoto, Morio

AU - Ishii, Ken

AU - Hikata, Tomohiro

AU - Seki, Shoji

AU - Terai, Hidetomi

AU - Suzuki, Akinobu

AU - Tamai, Koji

AU - Aramomi, Masaaki

AU - Ishikawa, Tetsuhiro

AU - Kimura, Atsushi

AU - Inoue, Hirokazu

AU - Inoue, Gen

AU - Miyagi, Masayuki

AU - Saito, Wataru

AU - Yamada, Kei

AU - Hongo, Michio

AU - Nishimura, Hirosuke

AU - Suzuki, Hidekazu

AU - Nakano, Atsushi

AU - Watanabe, Kazuyuki

AU - Chikuda, Hirotaka

AU - Ohya, Junichi

AU - Aoki, Yasuchika

AU - Shimizu, Masayuki

AU - Futatsugi, Toshimasa

AU - Mukaiyama, Keijiro

AU - Hasegawa, Masaichi

AU - Kiyasu, Katsuhito

AU - Iizuka, Haku

AU - Iizuka, Yoichi

AU - Kobayashi, Ryoichi

AU - Nishida, Kotaro

AU - Kakutani, Kenichiro

AU - Nakajima, Hideaki

AU - Murakami, Hideki

AU - Demura, Satoru

AU - Kato, Satoshi

AU - Yoshioka, Katsuhito

AU - Namikawa, Takashi

AU - Watanabe, Kei

AU - Nakanishi, Kazuyoshi

AU - Nakagawa, Yukihiro

AU - Yoshimoto, Mitsunori

AU - Fujiwara, Hiroyasu

AU - Nishida, Norihiro

AU - Imajo, Yasuaki

AU - Yamazaki, Masashi

AU - Sakane, Masataka

AU - Abe, Tetsuya

AU - Fujii, Kengo

AU - Kaito, Takashi

AU - Furuya, Takeo

AU - Orita, Sumihisa

AU - Ohtori, Seiji

PY - 2017/10/1

Y1 - 2017/10/1

N2 - Study Design: Retrospective study of registry data. Objectives: Aging of society and recent advances in surgical techniques and general anesthesia have increased the demand for spinal surgery in elderly patients. Many complications have been described in elderly patients, but a multicenter study of perioperative complications in spinal surgery in patients aged 80 years or older has not been reported. Therefore, the goal of the study was to analyze complications associated with spine surgery in patients aged 80 years or older with cervical, thoracic, or lumbar lesions. Methods: A multicenter study was performed in patients aged 80 years or older who underwent 262 spinal surgeries at 35 facilities. The frequency and severity of complications were examined for perioperative complications, including intraoperative and postoperative complications, and for major postoperative complications that were potentially life threatening, required reoperation in the perioperative period, or left a permanent injury. Results: Perioperative complications occurred in 75 of the 262 surgeries (29%) and 33 were major complications (13%). In multivariate logistic regression, age over 85 years (hazard ratio [HR] = 1.007, P = 0.025) and estimated blood loss ≥500 g (HR = 3.076, P =.004) were significantly associated with perioperative complications, and an operative time ≥180 min (HR = 2.78, P =.007) was significantly associated with major complications. Conclusions: Elderly patients aged 80 years or older with comorbidities are at higher risk for complications. Increased surgical invasion, and particularly a long operative time, can cause serious complications that may be life threatening. Therefore, careful decisions are required with regard to the surgical indication and procedure in elderly patients.

AB - Study Design: Retrospective study of registry data. Objectives: Aging of society and recent advances in surgical techniques and general anesthesia have increased the demand for spinal surgery in elderly patients. Many complications have been described in elderly patients, but a multicenter study of perioperative complications in spinal surgery in patients aged 80 years or older has not been reported. Therefore, the goal of the study was to analyze complications associated with spine surgery in patients aged 80 years or older with cervical, thoracic, or lumbar lesions. Methods: A multicenter study was performed in patients aged 80 years or older who underwent 262 spinal surgeries at 35 facilities. The frequency and severity of complications were examined for perioperative complications, including intraoperative and postoperative complications, and for major postoperative complications that were potentially life threatening, required reoperation in the perioperative period, or left a permanent injury. Results: Perioperative complications occurred in 75 of the 262 surgeries (29%) and 33 were major complications (13%). In multivariate logistic regression, age over 85 years (hazard ratio [HR] = 1.007, P = 0.025) and estimated blood loss ≥500 g (HR = 3.076, P =.004) were significantly associated with perioperative complications, and an operative time ≥180 min (HR = 2.78, P =.007) was significantly associated with major complications. Conclusions: Elderly patients aged 80 years or older with comorbidities are at higher risk for complications. Increased surgical invasion, and particularly a long operative time, can cause serious complications that may be life threatening. Therefore, careful decisions are required with regard to the surgical indication and procedure in elderly patients.

KW - complications

KW - elderly

KW - risk factor

KW - spine surgery

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