Abstract
Purpose: The comorbidities currently considered to increase surgical risk, particularly in the elderly, include heart disorders, diabetes, asthma, obesity, and chronic obstructive pulmonary disease (COPD). Further characterization of postoperative complications in relation to comorbidities is needed for lumbar decompression with fusion and instrumentation surgery.
Methods: A chart review was conducted on the hospital and office records of 121 patients who underwent this procedure between the years of 2000 and 2003. Comorbidities were evaluated based on their tendency to cause related complications. The rate of wound infections was determined due to their relation to diabetes and obesity.
Results: The age range was 65 to 89 years. Of 121 patients, 96 (79%) had comorbidities, and 12 (12.5%) of these had complications. There were 6 cardiac complications, 6 wound infections, and 2 diabetic challenges (1 patient experienced 3 complications). All 6 cardiac complication patients suffered from cardiac comorbidities. The wound infections presented in diabetics, obese patients, and cardiac disorder patients. Infections occurred in cardiac disorder patients only when diabetes and or obesity were present; 4 infected patients had this combination.
Conclusions: The comorbidity and complication that presented with the highest correlation was heart disorders. There were no associated complications with pulmonary diseases. Surgeons should be increasingly aware of the wound infection threat to their cardiac disorder combined with obesity and or diabetic patients. The low rate of comorbid elderly patients who experienced postoperative complications gives statistical indication of safety for elderly patients to pursue complex lumbar surgery.
Correspondence should be addressed to: Mr John O’ Dowd, SBPR, c/o BOA, The Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London WC2A 3PE.
