Incidence and Causes of In-Hospital Mortality Following Elective Spine Surgery in Elderly Patients: A Retrospective Multicenter Study of a Prospective Cohort
Introduction: Despite an increase in the demand for surgical treatment of elderly patients with degenerative spinal disorders, little is known about mortality following spinal surgery in this population. This study aims to identify the incidence and causes of in-hospital mortality in elderly patient...
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The Japanese Society for Spine Surgery and Related Research
2025-05-01
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| Series: | Spine Surgery and Related Research |
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| Online Access: | https://www.jstage.jst.go.jp/article/ssrr/9/3/9_2024-0225/_pdf/-char/en |
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| author | Shunsuke Ohira Yukimasa Yamato Yuki Taniguchi Naohiro Kawamura Tetsusai Iizuka Akiro Higashikawa Naoto Komatsu Yujiro Takeshita Keiichiro Tozawa Masayoshi Fukushima Daiki Urayama Takashi Ono Nobuhiro Hara Kazuhiro Masuda Seiichi Azuma Hiroki Iwai Masahito Oshina Shurei Sugita Shima Hirai Katsuyuki Sasaki Hiroyuki Nakarai Nozomu Ohtomo Hideki Nakamoto So Kato Yoshitaka Matsubayashi Sakae Tanaka Yasushi Oshima |
| author_facet | Shunsuke Ohira Yukimasa Yamato Yuki Taniguchi Naohiro Kawamura Tetsusai Iizuka Akiro Higashikawa Naoto Komatsu Yujiro Takeshita Keiichiro Tozawa Masayoshi Fukushima Daiki Urayama Takashi Ono Nobuhiro Hara Kazuhiro Masuda Seiichi Azuma Hiroki Iwai Masahito Oshina Shurei Sugita Shima Hirai Katsuyuki Sasaki Hiroyuki Nakarai Nozomu Ohtomo Hideki Nakamoto So Kato Yoshitaka Matsubayashi Sakae Tanaka Yasushi Oshima |
| author_sort | Shunsuke Ohira |
| collection | DOAJ |
| description | Introduction: Despite an increase in the demand for surgical treatment of elderly patients with degenerative spinal disorders, little is known about mortality following spinal surgery in this population. This study aims to identify the incidence and causes of in-hospital mortality in elderly patients after elective spine surgery.
Methods: We extracted the data of patients aged ≥65 years who underwent elective spine surgery between December 12, 2016, and May 31, 2022, from our prospective multicenter cohort. The primary outcome was the in-hospital mortality rate. Univariate analysis was conducted to identify potential risk factors for postoperative mortality. The detailed clinical course of patients who died was retrospectively investigated using medical records.
Results: A total of 10,976 eligible patients (5,976 males and 5,000 females), with a mean age of 75.5 years, were identified. There were eight in-hospital deaths (0.07%). Univariate analyses showed that the eight patients were significantly older (82.1 years vs. 75.5 years, P=0.008), were more frequently hemodialysis-dependent (50.0% vs. 2.9%, P<0.001), and had a higher proportion of cases with cervical surgery (62.5% vs. 17.0%, P<0.001) and preoperative American Society of Anesthesiologists Physical Status ≥3 (87.5% vs. 14.6%, P<0.001). Death occurred at a median of 24.5 days postoperatively. The causes of in-hospital death were as follows: gastrointestinal diseases in five cases (ischemic colitis in three cases, panperitonitis in one, and intestinal perforation in one), sepsis due to unknown causes in two, and lethal arrhythmia in one. The initial symptoms preceding the lethal clinical course were mainly common gastrointestinal symptoms, such as abdominal pain, anorexia, diarrhea, and vomiting.
Conclusions: The main cause of in-hospital mortality was gastrointestinal disease. Surgeons should be aware that common gastrointestinal symptoms can be the initial symptoms of a subsequent lethal clinical course in elderly patients. |
| format | Article |
| id | doaj-art-35638281d4da422faa2d32982c1cc075 |
| institution | DOAJ |
| issn | 2432-261X |
| language | English |
| publishDate | 2025-05-01 |
| publisher | The Japanese Society for Spine Surgery and Related Research |
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| series | Spine Surgery and Related Research |
| spelling | doaj-art-35638281d4da422faa2d32982c1cc0752025-08-20T03:11:03ZengThe Japanese Society for Spine Surgery and Related ResearchSpine Surgery and Related Research2432-261X2025-05-019333133810.22603/ssrr.2024-02252024-0225Incidence and Causes of In-Hospital Mortality Following Elective Spine Surgery in Elderly Patients: A Retrospective Multicenter Study of a Prospective CohortShunsuke Ohira0Yukimasa Yamato1Yuki Taniguchi2Naohiro Kawamura3Tetsusai Iizuka4Akiro Higashikawa5Naoto Komatsu6Yujiro Takeshita7Keiichiro Tozawa8Masayoshi Fukushima9Daiki Urayama10Takashi Ono11Nobuhiro Hara12Kazuhiro Masuda13Seiichi Azuma14Hiroki Iwai15Masahito Oshina16Shurei Sugita17Shima Hirai18Katsuyuki Sasaki19Hiroyuki Nakarai20Nozomu Ohtomo21Hideki Nakamoto22So Kato23Yoshitaka Matsubayashi24Sakae Tanaka25Yasushi Oshima26Department of Orthopaedic Surgery, The University of TokyoDepartment of Orthopaedic Surgery, The University of TokyoDepartment of Orthopaedic Surgery, The University of TokyoUniversity of Tokyo Spine Group (UTSG)University of Tokyo Spine Group (UTSG)University of Tokyo Spine Group (UTSG)University of Tokyo Spine Group (UTSG)University of Tokyo Spine Group (UTSG)University of Tokyo Spine Group (UTSG)University of Tokyo Spine Group (UTSG)University of Tokyo Spine Group (UTSG)University of Tokyo Spine Group (UTSG)University of Tokyo Spine Group (UTSG)University of Tokyo Spine Group (UTSG)University of Tokyo Spine Group (UTSG)Inanami Spine and Joint HospitalUniversity of Tokyo Spine Group (UTSG)University of Tokyo Spine Group (UTSG)University of Tokyo Spine Group (UTSG)Department of Orthopaedic Surgery, The University of TokyoDepartment of Orthopaedic Surgery, The University of TokyoDepartment of Orthopaedic Surgery, The University of TokyoDepartment of Orthopaedic Surgery, The University of TokyoDepartment of Orthopaedic Surgery, The University of TokyoDepartment of Orthopaedic Surgery, The University of TokyoDepartment of Orthopaedic Surgery, The University of TokyoDepartment of Orthopaedic Surgery, The University of TokyoIntroduction: Despite an increase in the demand for surgical treatment of elderly patients with degenerative spinal disorders, little is known about mortality following spinal surgery in this population. This study aims to identify the incidence and causes of in-hospital mortality in elderly patients after elective spine surgery. Methods: We extracted the data of patients aged ≥65 years who underwent elective spine surgery between December 12, 2016, and May 31, 2022, from our prospective multicenter cohort. The primary outcome was the in-hospital mortality rate. Univariate analysis was conducted to identify potential risk factors for postoperative mortality. The detailed clinical course of patients who died was retrospectively investigated using medical records. Results: A total of 10,976 eligible patients (5,976 males and 5,000 females), with a mean age of 75.5 years, were identified. There were eight in-hospital deaths (0.07%). Univariate analyses showed that the eight patients were significantly older (82.1 years vs. 75.5 years, P=0.008), were more frequently hemodialysis-dependent (50.0% vs. 2.9%, P<0.001), and had a higher proportion of cases with cervical surgery (62.5% vs. 17.0%, P<0.001) and preoperative American Society of Anesthesiologists Physical Status ≥3 (87.5% vs. 14.6%, P<0.001). Death occurred at a median of 24.5 days postoperatively. The causes of in-hospital death were as follows: gastrointestinal diseases in five cases (ischemic colitis in three cases, panperitonitis in one, and intestinal perforation in one), sepsis due to unknown causes in two, and lethal arrhythmia in one. The initial symptoms preceding the lethal clinical course were mainly common gastrointestinal symptoms, such as abdominal pain, anorexia, diarrhea, and vomiting. Conclusions: The main cause of in-hospital mortality was gastrointestinal disease. Surgeons should be aware that common gastrointestinal symptoms can be the initial symptoms of a subsequent lethal clinical course in elderly patients.https://www.jstage.jst.go.jp/article/ssrr/9/3/9_2024-0225/_pdf/-char/enin-hospital mortalitypostoperative deathelective spine surgeryelderly patientsgastrointestinal diseasehemodialysisischemic colitis |
| spellingShingle | Shunsuke Ohira Yukimasa Yamato Yuki Taniguchi Naohiro Kawamura Tetsusai Iizuka Akiro Higashikawa Naoto Komatsu Yujiro Takeshita Keiichiro Tozawa Masayoshi Fukushima Daiki Urayama Takashi Ono Nobuhiro Hara Kazuhiro Masuda Seiichi Azuma Hiroki Iwai Masahito Oshina Shurei Sugita Shima Hirai Katsuyuki Sasaki Hiroyuki Nakarai Nozomu Ohtomo Hideki Nakamoto So Kato Yoshitaka Matsubayashi Sakae Tanaka Yasushi Oshima Incidence and Causes of In-Hospital Mortality Following Elective Spine Surgery in Elderly Patients: A Retrospective Multicenter Study of a Prospective Cohort Spine Surgery and Related Research in-hospital mortality postoperative death elective spine surgery elderly patients gastrointestinal disease hemodialysis ischemic colitis |
| title | Incidence and Causes of In-Hospital Mortality Following Elective Spine Surgery in Elderly Patients: A Retrospective Multicenter Study of a Prospective Cohort |
| title_full | Incidence and Causes of In-Hospital Mortality Following Elective Spine Surgery in Elderly Patients: A Retrospective Multicenter Study of a Prospective Cohort |
| title_fullStr | Incidence and Causes of In-Hospital Mortality Following Elective Spine Surgery in Elderly Patients: A Retrospective Multicenter Study of a Prospective Cohort |
| title_full_unstemmed | Incidence and Causes of In-Hospital Mortality Following Elective Spine Surgery in Elderly Patients: A Retrospective Multicenter Study of a Prospective Cohort |
| title_short | Incidence and Causes of In-Hospital Mortality Following Elective Spine Surgery in Elderly Patients: A Retrospective Multicenter Study of a Prospective Cohort |
| title_sort | incidence and causes of in hospital mortality following elective spine surgery in elderly patients a retrospective multicenter study of a prospective cohort |
| topic | in-hospital mortality postoperative death elective spine surgery elderly patients gastrointestinal disease hemodialysis ischemic colitis |
| url | https://www.jstage.jst.go.jp/article/ssrr/9/3/9_2024-0225/_pdf/-char/en |
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