Incidence of sacral fractures and in-hospital postoperative complications in the united states: An analysis of 2002-2011 data

Mohamad Bydon, Rafael De La Garza-Ramos, Mohamed Macki, Atman Desai, Aaron K. Gokaslan, Ali Bydon

Research output: Contribution to journalArticle

12 Scopus citations

Abstract

STUDY DESIGN.: Retrospective study of an administrative database. OBJECTIVE.: To estimate the incidence of sacral fractures in the United States and report short-term outcomes after their surgical management. SUMMARY OF BACKGROUND DATA.: The incidence of sacral fractures in the United States is currently unknown, and these lesions have been associated with significant morbidity after their surgical management. METHODS.: This study used the Nationwide Inpatient Sample database for the years 2002-2011. All patients with a primary discharge diagnosis of a sacral fracture with and without a neurological injury were identified using International Classification of Diseases, Ninth Revision, Clinical Modification codes. Patients with a diagnosis of osteoporosis or pathological fracture were excluded. A stepwise multivariate logistic regression analysis was performed to identify factors associated with an in-hospital complication. RESULTS.: During the study period, 10,177 patients with a nonosteoporotic sacral fracture were identified, of whom 1002 patients underwent surgery. Between 2002 and 2011, the estimated incidence of sacral fractures increased from 0.67 per 100,000 persons to 2.09 (P < 0.001). Similarly, the rate of surgical treatment for sacral fractures increased from 0.05 per 100,000 persons in 2002 to 0.24 per 100,000 in 2011 (P < 0.001). Complications occurred in 25.95% of patients and remained steady over time (P = 0.992). Average length of stay significantly decreased from 11.93 days to 9.66 days in the 10-year period (P = 0.023). The independent factors associated with an in-hospital complication were congestive heart failure (odds ratio, 3.65; 95% confidence interval, 1.18-11.26), coagulopathy (odds ratio, 3.58; 95% confidence interval, 1.88-6.81), and electrolyte abnormalities (odds ratio, 3.28; 95% confidence interval, 2.14-5.02). CONCLUSION.: During the examined 10-year period, both the incidence of nonosteoporotic sacral fractures and the surgical treatment of these lesions increased in the United States. Between 2002 and 2011, although patient comorbidity increased, in-hospital complication rates remained stable and length of stay significantly decreased over time.

Original languageEnglish (US)
Pages (from-to)E1103-E1109
JournalSpine
Volume39
Issue number18
DOIs
StatePublished - Aug 15 2014

Keywords

  • Nationwide Inpatient Sample
  • complications
  • outcomes
  • sacral fractures
  • trends

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Clinical Neurology

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    Bydon, M., De La Garza-Ramos, R., Macki, M., Desai, A., Gokaslan, A. K., & Bydon, A. (2014). Incidence of sacral fractures and in-hospital postoperative complications in the united states: An analysis of 2002-2011 data. Spine, 39(18), E1103-E1109. https://doi.org/10.1097/BRS.0000000000000448