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Association between delayed ambulation and increased risk of adverse events after lumbar fusion surgery in elderly patients.
Wang, Shuai-Kang; Chai, Xin-Yi; Wang, Peng; Kong, Chao; Lu, Shi-Bao.
Afiliação
  • Wang SK; Department of Orthopedics & Elderly Spinal Surgery, National Clinical Research Center for Geriatric Diseases, Xuanwu Hospital of Capital Medical University, No.45 Changchun Street, Xicheng District, Beijing, 100053, China.
  • Chai XY; National Clinical Research Center for Geriatric Diseases, Beijing, 10053, China.
  • Wang P; Capital Medical University, Beijing, 10053, China.
  • Kong C; Department of Orthopedics & Elderly Spinal Surgery, National Clinical Research Center for Geriatric Diseases, Xuanwu Hospital of Capital Medical University, No.45 Changchun Street, Xicheng District, Beijing, 100053, China.
  • Lu SB; National Clinical Research Center for Geriatric Diseases, Beijing, 10053, China.
BMC Musculoskelet Disord ; 25(1): 501, 2024 Jun 27.
Article em En | MEDLINE | ID: mdl-38937718
ABSTRACT

PURPOSE:

The relationship between delayed ambulation (DA) and postoperative adverse events (AEs) following transforaminal lumbar interbody fusion (TLIF) in elderly patients remains elusive. The aim of our study was to evaluate the effects of DA on the postoperative AEs including complications, readmission and prolonged length of hospital stay (LOS).

METHODS:

This was a retrospective analysis of a prospectively established database of elderly patients (aged 65 years and older) who underwent TLIF surgery. The early ambulation (EA) group was defined as patients ambulated within 48 h after surgery, whereas the delayed ambulation (DA) group was patients ambulated at a minimum of 48 h postoperatively. The DA patients were 11 propensity-score matched to the EA patients based on age, gender and the number of fused segments. Univariate analysis was used to compare postoperative outcomes between the two groups, and multivariate logistic regression analysis was used to identify risk factors for adverse events and DA.

RESULTS:

After excluding 125 patients for various reasons, 1025 patients (≤ 48 h N = 659 and > 48 h N = 366) were included in the final analysis. After propensity score matching, there were 326 matched patients in each group. There were no significant differences in the baseline data and the surgery-related variables between the two groups (p > 0.05). The patients in the DA group had a significant higher incidence of postoperative AEs (46.0% vs. 34.0%, p = 0.002) and longer LOS (p = 0.001). Multivariate logistic regression identified that age, operative time, diabetes, and DA were independently associated with postoperative AEs, whereas greater age, higher international normalized ratio, and intraoperative estimated blood loss were identified as independent risk factors for DA.

CONCLUSIONS:

Delayed ambulation was an independent risk factor for postoperative AEs after TLIF in elderly patients. Older age, increased intraoperative blood loss and worse coagulation function were associated with delayed ambulation.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Complicações Pós-Operatórias / Fusão Vertebral / Tempo de Internação / Vértebras Lombares Limite: Aged / Aged80 / Female / Humans / Male Idioma: En Revista: BMC Musculoskelet Disord Assunto da revista: FISIOLOGIA / ORTOPEDIA Ano de publicação: 2024 Tipo de documento: Article País de afiliação: China

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Complicações Pós-Operatórias / Fusão Vertebral / Tempo de Internação / Vértebras Lombares Limite: Aged / Aged80 / Female / Humans / Male Idioma: En Revista: BMC Musculoskelet Disord Assunto da revista: FISIOLOGIA / ORTOPEDIA Ano de publicação: 2024 Tipo de documento: Article País de afiliação: China