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Long Term Outcomes and Effects of Surgery on Degenerative Spinal Deformity: A 14-Year National Cohort Study
- Source :
- Journal of Clinical Medicine, Volume 8, Issue 4, Journal of Clinical Medicine, Vol 8, Iss 4, p 483 (2019)
- Publication Year :
- 2019
- Publisher :
- Multidisciplinary Digital Publishing Institute, 2019.
-
Abstract
- Degenerative spinal deformity (DSD) has become a prevalent cause of disability and pain among the aging population worldwide. Though surgery has emerged as a promising option for DSD, the natural course, outcomes, and effects of surgery on DSD have remained elusive. This cohort study used a national database to comprehensively follow up patients of DSD for all-cause mortality, respiratory problems, and hip fracture-related hospitalizations. All patients were grouped into an operation or a non-operation group for comparison. An adjustment of demographics, comorbidities, and propensity-score matching was conducted to ameliorate confounders. A Cox regression hazard ratio (HR) model and Kaplan-Meier analysis were also applied. The study comprised 21,810 DSD patients, including 12,544 of the operation group and 9266 of the non-operation group. During the 14 years (total 109,591.2 person-years) of follow-up, the operation group had lower mortality (crude hazard ratio = 0.40), lower respiratory problems (cHR = 0.45), and lower hip fractures (cHR = 0.63) than the non-operation group (all p &lt<br />0.001). After adjustment, the risks for mortality and respiratory problems remained lower (adjusted HR = 0.60 and 0.65, both p &lt<br />0.001) in the operation than the non-operation group, while hip fractures were indifferent (aHR = 1.08, p &gt<br />0.05). Therefore, surgery for DSD is invaluable since it could reduce the risks of mortality and of hospitalization for respiratory problems.
- Subjects :
- Population ageing
medicine.medical_specialty
lcsh:Medicine
respiratory problems
Article
National cohort
surgery
03 medical and health sciences
0302 clinical medicine
Long term outcomes
Medicine
030212 general & internal medicine
Proportional hazards model
business.industry
lcsh:R
Confounding
Hazard ratio
General Medicine
mortality
Degenerative Spinal Deformity (DSD)
Surgery
hip fractures
Spinal deformity
business
030217 neurology & neurosurgery
Cohort study
Subjects
Details
- Language :
- English
- ISSN :
- 20770383
- Database :
- OpenAIRE
- Journal :
- Journal of Clinical Medicine
- Accession number :
- edsair.doi.dedup.....09f65a3a9dec155b14e77f37bc62af91
- Full Text :
- https://doi.org/10.3390/jcm8040483