Therapeutics and Clinical Risk Management (Jan 2020)
Risk Factors of Pulmonary Complications After Minimally Invasive Surgery for Elderly Patients with Vertebral Compression Fractures
Abstract
Hua-Xing Zhang, 1, 2 Yong Shen, 3 Jia Chen, 2 Long Zhang, 2 Wei Lin 1 1Department of Graduate School, Graduate School of Hebei Medical University, Shijiazhuang, Hebei 050000, People’s Republic of China; 2Department of Orthopedics, Hebei General Hospital, Shijiazhuang, Hebei 050000, People’s Republic of China; 3Department of Spine Surgery, The Third Affiliated Hospital of Hebei Medical University, Shijiazhuang, Hebei 050000, People’s Republic of ChinaCorrespondence: Yong ShenDepartment of Spine Surgery, The Third Affiliated Hospital of Hebei Medical University, No. 139, Ziqiang Road, Xinhua District, Shijiazhuang, Hebei, Province 050000, People’s Republic of ChinaTel +86- 18533112820Fax +86-0311-85988832Email [email protected]: To determine the risk factors for pulmonary complications after minimally invasive surgery in elderly patients with vertebral compression fractures (VCFs).Methods: A total of 233 elderly patients (age ≥ 65 years) with VCFs, who underwent percutaneous vertebroplasty (PVP) or percutaneous kyphoplasty (PKP) surgery at Hebei General Hospital from January 2011 to December 2016, were retrospectively analyzed. Risk factors and the effects of the model were determined by univariate logistic regression analyses and the receiver operating characteristic (ROC) curve, respectively. A risk assessment scale was established based on the risk factors, as well as physiological and surgical scores for mortality and morbidity. The risk assessment scale prospectively evaluated risk factors of pulmonary complications after minimally invasive surgery for elderly patients with VCFs from January to June 2017.Results: 27 patients were diagnosed with pulmonary complications (27/233, 11.59%). There were statistically significant differences between patients with and without pulmonary complications in terms of age, body mass index (BMI), smoking, cardiovascular diseases and old fractures between patients with and without pulmonary complications (P < 0.05). Logistic regression analysis showed that smoking, cardiovascular diseases and old fractures were risk factors (P < 0.05) and area under the curve was 0.738 (95% confidence intervals (CI): 0.648– 0.828). 53 elderly patients with VCFs were assessed, 5 of them occurred pulmonary complications. Areas under the curve of preoperative and total risk assessment values were all 0.925.Conclusion: Significant risk factors of pulmonary complications were BMI, cardiovascular diseases and old fractures for patients aged 65 years or elderly with VCFs after minimally invasive surgery. The risk assessment scale gained high accuracy.Keywords: vertebral compression fractures, pulmonary complications, risk factors, elderly patients
