P59. Predictive survival analysis of adult cervical deformity patients with 10-year follow-up

Abstract

<h3>BACKGROUND CONTEXT</h3> Previous studies have demonstrated that adult cervical deformity patients may be at increased risk of death in conjunction with increased frailty or weakened physiologic state. However, such studies have often been limited to two years, and longer-term studies are needed to better assess temporal changes in CD patients and associated mortality risk. <h3>PURPOSE</h3> To assess if patients with decreased comorbidities and physiologic burden will be at lessened risk of death for a greater length of time after undergoing adult cervical deformity surgery. <h3>STUDY DESIGN/SETTING</h3> Retrospective review of prospective cervical deformity (CD) database <h3>PATIENT SAMPLE</h3> A total of 290 CD patients. <h3>OUTCOME MEASURES</h3> Demographic factors; baseline comorbidities; intra/postoperative complications; mortality. <h3>METHODS</h3> Operative CD patients 18yrs with pre-(BL) and 10-year (10Y) data were included. Patients were stratified as Expired vs Living, as well as temporally grouped by Expiration prior to 5Y or between 5Y and 10Y. Group differences were assessed via means comparison analysis. Backstep logistic regression identified mortality predictors. Kaplan-Meier analysis assessed survivorship of expired patients. Log rank analysis determined differences in survival distribution groups. <h3>RESULTS</h3> Sixty-six total patients were included (58.11 ± 11.97 years, 48% female, 29.13 ± 6.89 kg/m2). Within 10Y, 20 (27.3% of CD cohort). At baseline, patients were comparable in age, gender, BMI, and CCI total on average (all p>.05). Furthermore, patients were comparable in BL HRQLs (all p>.05). However, patients who expired between 5Y and 10Y demonstrated higher BL EQ5D and mJOA scores than their earlier expired counterparts at 2Y (p.001). KM analysis found that by Passias et al., frailty, not frail patients had mean survival time of 170.56 weeks, vs 158.00 in frail patients (p=.949). <h3>CONCLUSIONS</h3> This study demonstrates that long-term survival after cervical deformity surgery may be predicted by baseline surgical factors. By optimizing BMI, frailty status and minimizing fusion length when appropriate, surgeons may be able to further assist CD patients in increasing their survivability post-operatively. <h3>FDA DEVICE/DRUG STATUS</h3> This abstract does not discuss or include any applicable devices or drugs.