Predictors of morbidity and mortality among @entity1 with cervical XXXX treated surgically.

@entity1 @entity712 @entity101 @entity353 @entity28 @entity602 @entity954
PURPOSE: The aim of this study is to report and quantify the associated factors for morbidity and mortality following surgical management of cervical @entity602 (CSM). METHODS: The Nationwide Inpatient Sample (NIS) database was use to retrospectively review all @entity1 over 25  years of age with a diagnosis of CSM who underwent anterior and/or posterior cervical fusion or laminoplasty between 2001 and 2010. The main outcome measures were total procedure-related complications and mortality. Multivariate regression analysis was used to identify demographic, comorbidity, and surgical parameters associated with increased morbidity and mortality risk [reported as: OR (95  % CI)]. RESULTS: A total of 54,348 @entity1 underwent surgical intervention for CSM with an overall morbidity rate of 9.83  % and mortality rate of 0.43  %. Comorbidities found to be associated with an increased complication rate included: pulmonary circulation disorders [6.92 (5.91-8.12)], pathologic @entity353 [3.42 (3.00-3.90)], and electrolyte imbalance [2.82 (2.65-3.01)]. Comorbidities found to be associated with an increased mortality rate included: @entity712 [4.59 (3.62-5.82)], pulmonary circulation disorders [11.29 (8.24-15.47)], and pathologic @entity353 [5.43 (4.07-7.26)]. Alternatively, @entity101 [0.56 (0.46-0.67)] and @entity28 [0.36 (0.22-0.61)] were found to confer a decreased risk of mortality. Increased morbidity and mortality rates were also identified for fusions of 4-8 levels [morbidity: 1.55 (1.48-1.62), mortality: 1.80 (1.48-2.18)] and for age >65  years [morbidity: 1.65 (1.57-1.72), mortality: 2.74 (2.25-3.34)]. An increased morbidity rate was found for posterior-only [1.55 (1.47-1.63)] and combined anterior and posterior fusions [3.20 (2.98-3.43)], and an increased mortality rate was identified for posterior-only fusions [1.87 (1.40-2.49)]. Although revision fusions were associated with an increased morbidity rate [1.81 (1.64-2.00)], they were associated with a decreased rate of mortality [0.24 (0.10-0.59)]. CONCLUSION: The NIS database was used to provide national estimates of morbidity and mortality following surgical management of CSM in the United States. Several comorbidities, as well as @entity954 , were identified as associated factors.
