Abstract

OBJECTIVE: To identify the impact of osteoporosis (OS) on postoperative outcomes in Medicare patients undergoing ASD surgery.BACKGROUND: Patients with OP and advanced age experience higher than average rates of ASD. However, poor bone density could undermine the durability of a deformity correction.METHODS: We queried the MarketScan Medicare Supplemental database to identify patients Medicare patients who underwent ASD surgery from 2007 to 2016.RESULTS: A total of 2564 patients met the inclusion criteria of this study, of whom n=971 (61.0%) were diagnosed with osteoporosis. Patients with OP had a similar 90-day postoperative complication rates (OP: 54.6% vs. non-OP: 49.2%, p=0.0076, not significant after multivariate regression correction). This was primarily driven by posthemorrhagic anemia (37.6% in OP, vs. 33.1% in non-OP). Rates of revision surgery were similar at 90days (non-OP 15.0%, OP 16.8%), but by 2years, OP patients had a significantly higher reoperation rate (30.4% vs. 22.9%, p<0.0001). In multivariate regression analysis, OP increased odds for revision surgery at 1year (OR 1.4) and 2years (OR 1.5) following surgery (all p<0.05). OP was also an independent predictor of readmission at all time points (90days, OR 1.3, p<0.005).CONCLUSION: Medicare patients with OP had elevated rates of complications, reoperations, and outpatient costs after undergoing primary ASD surgery.

View details for DOI 10.1007/s00586-021-06985-z

View details for PubMedID 34655336