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Characteristic Early Start (N = 771) Late Start (N = 269) P Value (Early vs Late Start) n (%) Mean ± SD n (%) Mean ± SD Age, y 44 ± 24 50 ± 22 0.10 BMI 25 ± 6 26 ± 7 0.52 ASA classification 2.4 ± 0.6 2.5 ± 0.6 0.14 mFI 0.4 ± 0.7 0.5 ± 0.7 0.10 Female sex 454 (59) 183 (68) 0.82 Comorbidities Diabetes mellitus 57 (7.4) 23 (8.6) 0.98 COPD 29 (3.8) 19 (7.1) 0.09 Cardiovascular disease 188 (24) 90 (34) 0.10 Osteoporosis 50 (6.5) 19 (7.1) 0.80 ASA, American Society of Anesthesiologists; BMI, body mass index; COPD, chronic obstructive pulmonary disease; mFI, modified frailty index.
- Table 2
Surgical characteristics of 1040 adults who underwent surgery for spinal deformity.
Characteristic Early Start (N = 771) Late Start (N = 269) P Value (Early vs Late Start) n (%) Mean ± SD n (%) Mean ± SD Mirza invasiveness index 21 ± 8.2 19.8 ± 8.8 0.04 Number of levels fused 10.4 ± 4.0 9.6 ± 4.4 0.01 Operative time (h) 6.9 ± 3.7 6.5 ± 3.0 0.12 3-Column osteotomy 88 (11) 37 (14) 0.85 Posterior column osteotomy 284 (37) 125 (46) 0.31 TLIF 192 (25) 96 (36) 0.04 ALIF 26 (3.4) 8 (3.0) 0.48 Multirod (>2) configuration 451 (58) 167 (62) 0.19 Estimated blood loss (mL) 1721 ± 1596 1466 ± 1297 0.16 Length of hospital stay (d) 6.5 ± 3.8 6.8 ± 3.9 0.20 ALIF, anterior lumbar interbody fusion; TLIF, transforaminal lumbar interbody fusion.
- Table 3
Complication and readmission/unplanned reoperation rates in early start vs late start cases.
Parameter Early Start (N = 771) Late Start (N = 269) P Value(Early vs Late Start) n % n % 90-d readmission 46 6.0 30 11.2 0.02 90-d unplanned reoperation 51 6.6 34 12.6 0.008 Neurologic complications Postoperative new onset radiculopathy 7 0.9 9 3.3 0.007 Residual central or foraminal stenosis with persistent radiculopathy 5 0.6 6 2.2 0.029 Parameter β Coefficient (95% CI) P Value 90-d readmission 1.8 (1.1–3.0) 0.02 Unplanned reoperation 1.9 (1.2–3.1) 0.009 Neurologic complication 2.1 (1.0–4.3) 0.046 Parameter Early Start (N = 771) Late Start (N = 269) P Value n % n % Overall number of complications 71 9.2 28 10.4 0.56 Instrumentation-related complication 13 1.7 8 3.0 0.20 Postoperative cerebrospinal fluid leak 11 1.4 4 1.5 0.94 Wound infection 7 0.9 6 2.2 0.09 Seroma 20 2.6 10 3.7 0.34 Pulmonary embolism 6 0.8 5 1.9 0.14 Deep venous thrombosis 5 0.6 3 1.1 0.45 Postoperative pneumonia 8 1.2 0 0 0.09 Ileus 10 1.3 4 1.5 0.82 Postoperative urinary retention 13 1.7 1 0.4 0.11 Sacral fracture 2 0.3 0 0 0.40 Delirium 5 0.6 2 0.7 0.87 Epidural hematoma 1 0.1 1 0.4 0.44 Mortality 2 0.3 2 0.7 0.27
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