Veterans’ preoperative risk factors predict complications after lumbar stenosis surgery

Researchers found that simple indicators of preoperative health, such as American Society of Anesthesiologists class, surgery type, corticosteroid and insulin use, were major predictors of complications following spinal stenosis surgery.

“Surgery for spinal stenosis is concentrated among older adults, for whom complications are more frequent than among middle-aged patients,” Richard A. Deyo, MD, MPH, stated in a press release.

Deyo and colleagues examined major medical complications of 12,154 veterans in the Veterans Affairs National Surgical Quality Improvement Program database between 1998 and 2009 who underwent lumbar stenosis surgery, according to the abstract. The researchers looked at complications such as acute myocardial infarction, cardiac arrest, pulmonary embolism, stroke, systemic sepsis, pneumonia and coma. Among these patients, the complication rate was 2.1% for major complications, 3.2% for wound complications and 0.6% for 90-day mortality.

The researchers also found fusion procedures had a higher complication rate than decompression surgery, and American Society of Anesthesiologists (ASA) class was a strong independent risk factor for complications after surgery in addition to preoperative status, corticosteroid use in the long-term and insulin use, according to the abstract. Further, Deyo and colleagues found the strongest predictors of complication after lumbar stenosis were age and ASA class IV.

Reference:

Deyo RA. Spine. 2013;doi:10.1097/BRS.0b013e31829f65c1.

Disclosure: Deyo has no relevant financial disclosures.