Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2012 Aug;21(8):1633-9.
doi: 10.1007/s00586-012-2298-8. Epub 2012 Apr 18.

Perioperative mortality after lumbar spinal fusion surgery: an analysis of epidemiology and risk factors

Matthias Pumberger  1 , Ya Lin Chiu, Yan Ma, Federico P Girardi, Vassilios Vougioukas, Stavros G Memtsoudis
Affiliations

Perioperative mortality after lumbar spinal fusion surgery: an analysis of epidemiology and risk factors

Matthias Pumberger et al. Eur Spine J. 2012 Aug.

Abstract

Study design: Analysis of the Nationwide Inpatient Sample (NIS) from 1998 to 2008.

Objective: To analyze the most recent available and nationally representative data for risk factors contributing to in-hospital mortality after primary lumbar spine fusion.

Summary of background data: The total number of lumbar spine fusion surgeries has increased dramatically over the past decades. While the field of spine fusion surgery remains highly dynamic with changes in perioperative care constantly affecting patient care, recent data affecting rates and risk for perioperative mortality remain very limited.

Methods: We obtained the NIS from the Hospital cost and utilization project. The impact of patient and health care system related demographics, including various comorbidities as well as postoperative complications on the outcome of in-hospital mortality after spine fusion were studied. Furthermore, we analyzed the timing of in-hospital mortality.

Results: An estimated total of 1,288,496 primary posterior lumbar spine fusion procedures were performed in the US between 1998 and 2008. The average mortality rate for lumbar spine fusion surgery was 0.2%. Independent risk factors for in-hospital mortality included advanced age, male gender, large hospital size, and emergency admission. Comorbidities associated with the highest in-hospital mortality after lumbar spine fusion surgery were coagulopathy, metastatic cancer, congestive heart failure and renal disease. Most lethal complications were cerebrovascular events, sepsis and pulmonary embolism. Furthermore, we demonstrated that the timing of death occurred relatively early in the in-hospital period with over half of fatalities occurring by postoperative day 9.

Conclusion: This study provides nationally representative information on risk factors for and timing of perioperative mortality after primary lumbar spine fusion surgery. These data can be used to assess risk for this event and to develop targeted intervention to decrease such risk.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
This figure depicts the in-hospital mortality over the length of stay
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Garrett WE, Jr, Swiontkowski MF, Weinstein JN, et al. American board of orthopaedic surgery practice of the orthopaedic surgeon: part-II, certification examination case mix. J Bone Joint Surg Am. 2006;88:660–667. doi: 10.2106/JBJS.E.01208. - DOI - PubMed
    1. Oldridge NB, Yuan Z, Stoll JE, et al. Lumbar spine surgery and mortality among medicare beneficiaries, 1986. Am J Public Health. 1994;84:1292–1298. doi: 10.2105/AJPH.84.8.1292. - DOI - PMC - PubMed
    1. Ma Y, Passias P, Gaber-Baylis LK, et al. Comparative in-hospital morbidity and mortality after revision versus primary thoracic and lumbar spine fusion. Spine J. 2010;10:881–889. doi: 10.1016/j.spinee.2010.07.391. - DOI - PMC - PubMed
    1. Juratli SM, Mirza SK, Fulton-Kehoe D, et al. Mortality after lumbar fusion surgery. Spine. 2009;34:740–747. doi: 10.1097/BRS.0b013e31819b2176. - DOI - PubMed
    1. Li G, Patil CG, Lad SP, et al. Effects of age and comorbidities on complication rates and adverse outcomes after lumbar laminectomy in elderly patients. Spine. 2008;33:1250–1255. doi: 10.1097/BRS.0b013e3181714a44. - DOI - PubMed

Publication types