A new study published in Spine examines how age affects cervical spondylotic myelopathy treatment.
The researchers examined the Nationwide Inpatient Sample from 2001 to 2010, including cervical spondylotic myelopathy patients who were 25 years or older and underwent anterior and/or posterior cervical fusion or laminoplasty. There were 35,319 patients from 25 to 64 years old included and 19,097 patients 65 years or older.
The researchers found:
1. There were more comorbidities for the 65 years and older patients—0.79 compared with 0.44 comorbidity indicies — and the total complication rate was higher. More than 11 percent of the older patients reported complications compared with 5.93 percent of the younger patients.
2. The older patients had a higher cost of care than the younger patients. The charges for the 65 years and older group were $57,449 on average, compared with $49,951 for the younger group.
3. The hospital course for the older patients was 4.7 days, compared with 3.6 days for the younger patients and the mortality risk was higher for the older patients.
4. The older patient group had an increased risk for all complications except device-related complications; the older group had a decreased risk for device-related complications.
5. The hospital charges for patients 76 years and older was $59,197, compared with $56,601 for patients age 65 to 75 and the course was also longer at 5.77 days compared with 4.28 days.
6. The patients older than 76 years old presented with higher Deyo scores and reported a higher complication rate — 13.87 percent, compared with 10.2 percent for the patients age 65 to 75.
7. The patients who were 76 years or older reported increased postoperative shock risk, digestive system and wound dehiscence.
"Patients aged 65+ years undergoing CSM surgical management have a higher mortality risk, more procedure-related complications, higher comorbidity burden, longer hospital course and higher charges," concluded the study authors.