Factors Associated With Major Complications and Mortality During Hospitalization in Patients With Ankylosing Spondylitis Undergoing Surgical Management for a Spine Fracture

Global Spine Journal, 2022 · DOI: 10.1177/2192568220980702 · Published: January 1, 2022

Simple Explanation

This study looks at the complications and death rates for patients with ankylosing spondylitis (AS) who have spine fractures and undergo surgery. The researchers analyzed data from 166 patients treated at a single hospital over 16 years to identify factors that increase the risk of complications like infections, implant failures, pneumonia, and death. The findings can help doctors better understand the risks and provide more accurate information to patients and their families about what to expect after surgery.

Study Duration

2003-2019 (16 years)

Participants

166 patients with ankylosing spondylitis and spine fractures

Evidence Level

Retrospective monocentric study

Key Findings

1
Prolonged ICU stay (>48 hours) is associated with major complications, including death.
2
Posterior surgical approach, prolonged ICU stay, and cervical spinal cord injury are linked to major complications, excluding death.
3
Age over 70, nosocomial pneumonia, and a Charlson Comorbidity Index score greater than 5 are significantly associated with in-hospital mortality.

Research Summary

The study aimed to analyze factors associated with major complications (MC) in patients with ankylosing spondylitis (AS) undergoing surgical management for spine fractures, finding high incidences of surgical site infection (17.2%), implant failure (9.2%), nosocomial pneumonia (31%), and in-hospital mortality (14.9%). Multivariable regression analyses identified ICU stay > 48 hours as significantly associated with MC (including death); posterior approach for spondylodesis, ICU stay > 48 hours, and cervical SCI were related to MC (excluding death); and age > 70 years, NP, and CCI > 5 points were associated with in-hospital mortality. The authors conclude that patients with AS undergoing surgical treatment for spine fractures are at high risk for MC, and the identified factors can help physicians provide prognostic information and improve patient and family expectations.

Practical Implications

Improved Patient Counseling

Physicians can use these findings to better counsel patients and their families about the risks associated with surgery for spine fractures in AS.

Risk Stratification

The identified risk factors can help in stratifying patients based on their likelihood of developing complications or mortality.

Optimized Postoperative Care

Targeted interventions can be implemented to reduce the risk of complications, such as minimizing ICU stay and preventing nosocomial pneumonia.

Study Limitations

1
Retrospective study design may lead to underreporting of comorbidities and mortality.
2
Lack of a control group limits the ability to determine independent predictors of major complications.
3
Follow-up data beyond 12 weeks was not analyzed, potentially missing later complications.

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