Risk Factors Associated with 30-Day Mortality After Open Reduction and Internal Fixation of Vertebral Fractures

Abstract

Few studies have examined the outcomes of open reduction and internal fixation of vertebral fractures. The purpose of this study was to determine patient-related and surgery-related risk factors associated with 30-day postoperative mortality after open reduction and internal fixation (ORIF) of cervical, thoracic, and lumbar vertebral fractures. This was a retrospective cohort study of data from the 2010-2014 ACS-NSQIP database. Adult patients who underwent ORIF of vertebral fractures in the cervical, thoracic, or lumbar spine were included. Patients were divided into 2 groups on the basis of the occurrence of 30-day postoperative mortality. A univariate analysis was performed to compare baseline patient characteristics, comorbidities, operative variables, and 30-day postoperative complications between the mortality and nonmortality groups. A subsequent multivariate regression analysis adjusting for patient and operative factors was then performed to identify independent risk factors for 30-day mortality. A total of 900 patients who underwent vertebral ORIF were included. The overall 30-day postoperative mortality rate was 1.56%. The mortality group had a higher incidence of pneumonia, pulmonary complications, cardiac complications, blood transfusion, sepsis, and prolonged hospitalization. Multivariate regression analysis identified pulmonary comorbidity and diabetes as independent predictors of 30-day mortality following ORIF of vertebral fractures. Pulmonary comorbidity and diabetes were found to be independent risk factors for 30-day mortality after ORIF of vertebral fractures. Recognizing these risk factors is important in preoperative risk stratification, perioperative care, and patient counseling.