In-hospital mortality trends after surgery for traumatic thoracolumbar injury: A national inpatient sample database study

Introduction: Given the increasing incidence of traumatic thoracolumbar injuries in recent years, studies have sought to investigate potential risk factors for outcomes in these patients. Research question: The aim of this study was to investigate trends and risk factors for in-hospital mortality af...

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Main Authors: Michael McCurdy, Rajkishen Narayanan, Omar Tarawneh, Yunsoo Lee, Matthew Sherman, Teeto Ezeonu, Michael Carter, Jose A. Canseco, Alan S. Hilibrand, Alexander R. Vaccaro, Christopher K. Kepler, Gregory D. Schroeder
Format: Article
Language:English
Published: Elsevier 2024-01-01
Series:Brain and Spine
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Online Access:http://www.sciencedirect.com/science/article/pii/S277252942400033X
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author Michael McCurdy
Rajkishen Narayanan
Omar Tarawneh
Yunsoo Lee
Matthew Sherman
Teeto Ezeonu
Michael Carter
Jose A. Canseco
Alan S. Hilibrand
Alexander R. Vaccaro
Christopher K. Kepler
Gregory D. Schroeder
author_facet Michael McCurdy
Rajkishen Narayanan
Omar Tarawneh
Yunsoo Lee
Matthew Sherman
Teeto Ezeonu
Michael Carter
Jose A. Canseco
Alan S. Hilibrand
Alexander R. Vaccaro
Christopher K. Kepler
Gregory D. Schroeder
author_sort Michael McCurdy
collection DOAJ
description Introduction: Given the increasing incidence of traumatic thoracolumbar injuries in recent years, studies have sought to investigate potential risk factors for outcomes in these patients. Research question: The aim of this study was to investigate trends and risk factors for in-hospital mortality after fusion for traumatic thoracolumbar injury. Materials and methods: Patients undergoing thoracolumbar fusion after traumatic injury were queried from the National Inpatient Sample (NIS) from 2012 to 2017. Analysis was performed to identify risk factors for inpatient mortality after surgery. Results: Patients in 2017 were on average older (51.0 vs. 48.5, P = 0.004), had more admitting diagnoses (15.5 vs. 10.7, p < 0.001), were less likely to be White (75.8% vs. 81.2%, p = 0.006), were from a ZIP code with a higher median income quartile (Quartile 1: 31.4% vs. 28.6%, p = 0.011), and were more likely to have Medicare as a primary payer (22.9% vs. 30.1%, p < 0.001). Bivariate analysis of demographics and surgical characteristics demonstrated that patients in the in-hospital mortality group (n = 90) were older (70.2 vs. 49.6, p < 0.001), more likely to be male (74.4% vs. 62.8%, p = 0.031), had a great number of admitted diagnoses (21.3 vs. 12.7, p < 0.001), and were more likely to be insured by Medicare (70.0% vs. 27.0%, p < 0.001). Multivariate regression analysis found age (OR 1.06, p < 0.001) and Black race (OR 3.71, p = 0.007) were independently associated with in-hospital mortality. Conclusion: Our study of nationwide, traumatic thoracolumbar fusion procedures from 2012 to 2017 in the NIS database found older, black patients were at increased risk for in-hospital mortality after surgery.
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spelling doaj-art-8ad0ea8eaa694643a701ef57ce6ba0cb2025-08-20T02:35:40ZengElsevierBrain and Spine2772-52942024-01-01410277710.1016/j.bas.2024.102777In-hospital mortality trends after surgery for traumatic thoracolumbar injury: A national inpatient sample database studyMichael McCurdy0Rajkishen Narayanan1Omar Tarawneh2Yunsoo Lee3Matthew Sherman4Teeto Ezeonu5Michael Carter6Jose A. Canseco7Alan S. Hilibrand8Alexander R. Vaccaro9Christopher K. Kepler10Gregory D. Schroeder11Department of Orthopaedic Surgery, Rothman Orthopaedic Institute at Thomas Jefferson University Hospital, Philadelphia, PA, USACorresponding author.Rothman Orthopaedic Institute at Thomas Jefferson University 925 Chestnut St, 5th Floor Philadelphia, PA, 19107, USA; Department of Orthopaedic Surgery, Rothman Orthopaedic Institute at Thomas Jefferson University Hospital, Philadelphia, PA, USADepartment of Orthopaedic Surgery, Rothman Orthopaedic Institute at Thomas Jefferson University Hospital, Philadelphia, PA, USADepartment of Orthopaedic Surgery, Rothman Orthopaedic Institute at Thomas Jefferson University Hospital, Philadelphia, PA, USADepartment of Orthopaedic Surgery, Rothman Orthopaedic Institute at Thomas Jefferson University Hospital, Philadelphia, PA, USADepartment of Orthopaedic Surgery, Rothman Orthopaedic Institute at Thomas Jefferson University Hospital, Philadelphia, PA, USADepartment of Orthopaedic Surgery, Rothman Orthopaedic Institute at Thomas Jefferson University Hospital, Philadelphia, PA, USADepartment of Orthopaedic Surgery, Rothman Orthopaedic Institute at Thomas Jefferson University Hospital, Philadelphia, PA, USADepartment of Orthopaedic Surgery, Rothman Orthopaedic Institute at Thomas Jefferson University Hospital, Philadelphia, PA, USADepartment of Orthopaedic Surgery, Rothman Orthopaedic Institute at Thomas Jefferson University Hospital, Philadelphia, PA, USADepartment of Orthopaedic Surgery, Rothman Orthopaedic Institute at Thomas Jefferson University Hospital, Philadelphia, PA, USADepartment of Orthopaedic Surgery, Rothman Orthopaedic Institute at Thomas Jefferson University Hospital, Philadelphia, PA, USAIntroduction: Given the increasing incidence of traumatic thoracolumbar injuries in recent years, studies have sought to investigate potential risk factors for outcomes in these patients. Research question: The aim of this study was to investigate trends and risk factors for in-hospital mortality after fusion for traumatic thoracolumbar injury. Materials and methods: Patients undergoing thoracolumbar fusion after traumatic injury were queried from the National Inpatient Sample (NIS) from 2012 to 2017. Analysis was performed to identify risk factors for inpatient mortality after surgery. Results: Patients in 2017 were on average older (51.0 vs. 48.5, P = 0.004), had more admitting diagnoses (15.5 vs. 10.7, p < 0.001), were less likely to be White (75.8% vs. 81.2%, p = 0.006), were from a ZIP code with a higher median income quartile (Quartile 1: 31.4% vs. 28.6%, p = 0.011), and were more likely to have Medicare as a primary payer (22.9% vs. 30.1%, p < 0.001). Bivariate analysis of demographics and surgical characteristics demonstrated that patients in the in-hospital mortality group (n = 90) were older (70.2 vs. 49.6, p < 0.001), more likely to be male (74.4% vs. 62.8%, p = 0.031), had a great number of admitted diagnoses (21.3 vs. 12.7, p < 0.001), and were more likely to be insured by Medicare (70.0% vs. 27.0%, p < 0.001). Multivariate regression analysis found age (OR 1.06, p < 0.001) and Black race (OR 3.71, p = 0.007) were independently associated with in-hospital mortality. Conclusion: Our study of nationwide, traumatic thoracolumbar fusion procedures from 2012 to 2017 in the NIS database found older, black patients were at increased risk for in-hospital mortality after surgery.http://www.sciencedirect.com/science/article/pii/S277252942400033XThoracolumbar traumaMortalitySocioeconomicRisk factorsSpine surgery
spellingShingle Michael McCurdy
Rajkishen Narayanan
Omar Tarawneh
Yunsoo Lee
Matthew Sherman
Teeto Ezeonu
Michael Carter
Jose A. Canseco
Alan S. Hilibrand
Alexander R. Vaccaro
Christopher K. Kepler
Gregory D. Schroeder
In-hospital mortality trends after surgery for traumatic thoracolumbar injury: A national inpatient sample database study
Brain and Spine
Thoracolumbar trauma
Mortality
Socioeconomic
Risk factors
Spine surgery
title In-hospital mortality trends after surgery for traumatic thoracolumbar injury: A national inpatient sample database study
title_full In-hospital mortality trends after surgery for traumatic thoracolumbar injury: A national inpatient sample database study
title_fullStr In-hospital mortality trends after surgery for traumatic thoracolumbar injury: A national inpatient sample database study
title_full_unstemmed In-hospital mortality trends after surgery for traumatic thoracolumbar injury: A national inpatient sample database study
title_short In-hospital mortality trends after surgery for traumatic thoracolumbar injury: A national inpatient sample database study
title_sort in hospital mortality trends after surgery for traumatic thoracolumbar injury a national inpatient sample database study
topic Thoracolumbar trauma
Mortality
Socioeconomic
Risk factors
Spine surgery
url http://www.sciencedirect.com/science/article/pii/S277252942400033X
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