Risk factors of pulmonary complications after minimally invasive surgery for elderly patients with vertebral compression fractures

Abstract

Purpose: To determine the risk factors for pulmonary complications after minimally invasive surgery in elderly patients with vertebral compression fractures (VCFs). Methods: We retrospectively analyzed 233 elderly patients (age ≥ 65 years) with VCFs who underwent percutaneous vertebroplasty (PVP) or percutaneous kyphoplasty (PKP) surgery at Hebei General Hospital from January 2011 to December 2016 . Risk factors and the effects of the model were determined by univariate logistic regression analyses and the receiver operating characteristic (ROC) curve, respectively. A risk assessment scale was established based on the risk factors and physiological and surgical scores for mortality and morbidity. The risk assessment scale prospectively evaluated risk factors of pulmonary complications after minimally invasive surgery for elderly patients with VCFs from January to June 2017. Results: A total of 27 patients diagnosed with pulmonary complications (11.59%) among 233 detected patients. There were statistically significant differences in age, body mass index (BMI), smoking, cardiovascular diseases and old fractures between patients with and without pulmonary complications (P<0.05). Logistic regression analysis showed that smoking, cardiovascular diseases and old fractures were risk factors of pulmonary complications after PVP or PKP for elderly patients with VCFs (P<0.05) and area under the curve was 0.738 (95% confidence intervals (CI): 0.648-0.828). We assessed 53 elderly patients with VCFs, 5 of whom occurred pulmonary complications after PVP or PKP. Areas under the curve of preoperative and total risk assessment values were all 0.925. Conclusions: Significant risk factors of pulmonary complications were BMI, cardiovascular diseases and old fractures for patients aged 65 years or elderly with VCFs after minimally invasive surgery. The risk assessment scale established by us gaining high accuracy.

Predictive Characteristics and Model Development for Acute Heart Failure Preceding Hip Fracture Surgery in Elderly Hypertensive Patients: A Retrospective Machine Learning Approach

“…In elderly patients with hypertension, the occurrence of complications following a hip fracture signi cantly increases the risk of acute heart failure. Particularly in the respiratory system, common postfracture pulmonary complications such as pneumonia and pulmonary embolism can cause hypoxemia and increased cardiac stress, further burdening the already strained heart due to hypertension 29 . Digestive system complications, such as gastric ulcers and gastrointestinal bleeding, may be exacerbated by the prolonged bed rest and use of analgesics necessary after hip surgery, leading to reduced blood volume and altered cardiac preload 30 .…”

Is Osteoporotic Thoracolumbar Burst Fracture a Contraindication to Percutaneous Kyphoplasty? A Systematic Review

“…Previous studies reported that, in osteoporotic thoracolumbar burst fracture, the decrease in the height of the anterior and posterior edges of the vertebral body, fractures of different degrees in the posterior wall of the vertebral body, and vertebral cortical defect, all appeared to be risk factors of cement leakage (11). Additionally, some scholars consider that it is easy to make fracture segments shift into the spinal canal and leak cement along the cortex behind the ruptured vertebral body by percutaneous kyphoplasty (12)(13)(14). Hence, osteoporotic patients with thoracolumbar burst fractures have been regarded as a contraindication for the treatment of percutaneous kyphoplasty.…”