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 SaitoKei 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

18 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

Keywords

  • complications
  • elderly
  • risk factor
  • spine surgery

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine
  • Clinical Neurology

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    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., ... 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, 7(7), 636-641. https://doi.org/10.1177/2192568217716144