Acta Neurochirurgica

, Volume 159, Issue 3, pp 517–525

National trends following decompression, discectomy, and fusion in octogenarians and nonagenarians

  • Doniel Drazin
  • Carlito Lagman
  • Siddharth Bhargava
  • Miriam Nuño
  • Terrence T. Kim
  • J. Patrick Johnson
Original Article - Spine

DOI: 10.1007/s00701-016-3056-1

Cite this article as:
Drazin, D., Lagman, C., Bhargava, S. et al. Acta Neurochir (2017) 159: 517. doi:10.1007/s00701-016-3056-1

Abstract

Background

The National Inpatient Sample (NIS) database is used to evaluate a wide variety of surgical procedures across a range of specialties. The authors of this study assess national trends of the three commonest spine procedures performed (decompression, fusion, and discectomy) in patients between the ages of 80 and 100 years (octogenarians and nonagenarians).

Methods

The NIS database was queried to identify patients between the ages of 80 and 100 with a primary diagnosis of spinal stenosis, disk herniation without myelopathy, or protrusion due to degeneration of spine/disk disorders and who have undergone spinal decompression, fusion, or discectomy between the years 1998 and 2011. Variables of concern included length-of-stay (LOS), non-routine discharge, average total charges, in-hospital complications, and mortality rate.

Results

Decompression was the most common procedure performed (n = 113,267, 50.5%). Fusion (n = 60,345, 26.9%) was associated with the longest LOS (5.1 days), highest in-hospital complication and mortality rates (n = 13,170, 21.8% and n = 449, 0.7%, respectively), most non-routine discharges (n = 42,662, 70.7%), and highest mean for average total charges ($69,295) (p < 0.001). Discectomy (n = 50,740, 22.6%), had the shortest LOS (3.7 days), lowest complication and mortality rates (n = 6823, 13.4% and n = 102, 0.2%, respectively), fewest non-routine discharges (n = 22,861, 45.1%), and lowest mean for average total charges ($22,787) (p < 0.001).

Conclusions

Decompression was most common. Fusion had the longest LOS, highest complication and mortality rates, most non-routine discharges, and was most expensive. Discectomy was least commonly performed, had the shortest LOS, lowest complication and mortality rates, fewest non-routine discharges, and was least expensive.

Keywords

Aged 80 and over Decompression Discectomy Spinal fusion 

Copyright information

© Springer-Verlag Wien 2017

Authors and Affiliations

  • Doniel Drazin
    • 1
  • Carlito Lagman
    • 1
  • Siddharth Bhargava
    • 1
  • Miriam Nuño
    • 1
  • Terrence T. Kim
    • 2
  • J. Patrick Johnson
    • 1
  1. 1.Department of NeurosurgeryCedars-Sinai Medical CenterLos AngelesUSA
  2. 2.Department of Orthopedic SurgeryCedars-Sinai Medical CenterLos AngelesUSA

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