Table 1.
Patient Demographics, Hospital Characteristics, and Outcomes for Lumbar Fusions in Octogenarians.a
| 2004 | 2005 | 2006 | 2007 | 2008 | 2009 | 2010 | 2011 | 2012 | 2013 | P | |
|---|---|---|---|---|---|---|---|---|---|---|---|
| No. of total fusions | 1144 | 1224 | 1292 | 1633 | 1780 | 2014 | 2032 | 2324 | 1967 | 2061 | |
| Multilevel fusions | 209 (18.3) | 260 (21.2) | 224 (17.3) | 337 (20.6) | 271 (15.2) | 387 (19.2) | 362 (17.8) | 448 (19.3) | 317 (16.1) | 347 (16.8) | .3629 |
| Mean age (years) | 82.6 | 82.5 | 82.7 | 82.6 | 82.6 | 82.6 | 82.8 | 82.7 | 82.7 | 82.7 | .1295 |
| Female* | 780 (68.2) | 771 (63) | 839 (64.9) | 1061 (65) | 1118 (62.8) | 1213 (60.2) | 1284 (63.2) | 1379 (59.3) | 1178 (59.9) | 1185 (57.5) | <.0001 |
| Race | |||||||||||
| White* | 807 (70.5) | 840 (68.6) | 857 (66.3) | 1082 (66.3) | 1316 (73.9) | 1559 (77.4) | 1624 (79.9) | 1919 (82.6) | 1652 (84) | 1739 (84.4) | <.0001 |
| Black | 17 (1.5) | 21 (1.7) | 26 (2) | 28 (1.7) | 34 (1.9) | 34 (1.7) | 38 (1.9) | 59 (2.5) | 49 (2.5) | 48 (2.3) | .1107 |
| Other* | 45 (3.9) | 55 (4.5) | 54 (4.2) | 74 (4.5) | 104 (5.8) | 137 (6.8) | 123 (6.1) | 160 (6.9) | 159 (8.1) | 161 (7.8) | .0009 |
| Comorbidity | |||||||||||
| 0 | 138 (12.1) | 123 (10) | 105 (8.1) | 134 (8.2) | 158 (8.9) | 207 (10.3) | 194 (9.5) | 190 (8.2) | 164 (8.3) | 179 (22.1) | .0078 |
| 1 | 300 (26.2) | 318 (26) | 296 (22.9) | 408 (25) | 423 (23.8) | 414 (20.6) | 462 (22.7) | 473 (20.4) | 392 (19.9) | 455 (23.9) | .0094 |
| 2* | 345 (30.2) | 348 (28.4) | 410 (31.7) | 438 (26.8) | 503 (28.3) | 547 (27.2) | 502 (24.7) | 579 (24.9) | 539 (27.4) | 492 (45.4) | <.0001 |
| 3* | 361 (31.6) | 435 (35.5) | 481 (37.2) | 653 (40) | 696 (39.1) | 846 (42) | 874 (43) | 1082 (46.6) | 872 (44.3) | 935 (45.4) | <.0001 |
| Health care insurance | |||||||||||
| Medicare | 1088 (95.1) | 1153 (94.2) | 1226 (94.9) | 1530 (93.7) | 1637 (92) | 1863 (92.5) | 1931 (95) | 2204 (94.8) | 1851 (94.1) | 1945 (94.4) | .4952 |
| Medicaid | 2 (0.2) | 4 (0.3) | 3 (0.2) | 2 (0.1) | 6 (0.3) | 5 (0.2) | 9 (0.4) | 3 (0.1) | 4 (0.2) | 6 (0.3) | .5534 |
| Uninsured | 6 (0.5) | 0 (0) | 2 (0.2) | 4 (0.2) | 8 (0.4) | 5 (0.2) | 2 (0.1) | 3 (0.1) | 8 (0.4) | 4 (0.2) | .0945 |
| Private | 43 (3.8) | 62 (5.1) | 49 (3.8) | 86 (5.3) | 100 (5.6) | 120 (6) | 75 (3.7) | 94 (4) | 87 (4.4) | 84 (4.1) | .7281 |
| Academic hospital | 619 (54.1) | 566 (46.2) | 645 (49.9) | 825 (50.5) | 874 (49.1) | 909 (45.1) | 867 (42.7) | 1150 (49.5) | 987 (50.2) | 1064 (51.6) | .6636 |
| Hospital size | |||||||||||
| Small | 191 (16.7) | 181 (14.8) | 144 (11.1) | 232 (14.2) | 224 (12.6) | 263 (13.1) | 313 (15.4) | 322 (13.9) | 267 (13.6) | 296 (14.4) | .6309 |
| Medium | 224 (19.6) | 248 (20.3) | 284 (22) | 276 (16.9) | 434 (24.4) | 430 (21.4) | 391 (19.2) | 483 (20.8) | 452 (23) | 531 (25.8) | .0278 |
| Large | 729 (63.7) | 795 (65) | 864 (66.9) | 1125 (68.9) | 1122 (63) | 1291 (64.1) | 1311 (64.5) | 1499 (64.5) | 1248 (63.4) | 1234 (59.9) | .1467 |
| Hospital region | |||||||||||
| Northeast | 183 (16) | 167 (13.6) | 173 (13.4) | 228 (14) | 277 (15.6) | 305 (15.1) | 299 (14.7) | 360 (15.5) | 318 (16.2) | 301 (14.6) | .6386 |
| South | 435 (38) | 447 (36.5) | 522 (40.4) | 579 (35.5) | 682 (38.3) | 794 (39.4) | 774 (38.1) | 919 (39.5) | 724 (36.8) | 785 (38.1) | .6995 |
| Midwest | 261 (22.8) | 296 (24.2) | 327 (25.3) | 449 (27.5) | 437 (24.6) | 459 (22.8) | 504 (24.8) | 541 (23.3) | 481 (24.5) | 488 (23.7) | .8746 |
| West | 265 (23.2) | 314 (25.7) | 270 (20.9) | 377 (23.1) | 384 (21.6) | 456 (22.6) | 455 (22.4) | 504 (21.7) | 444 (22.6) | 487 (23.6) | .987 |
| Mortality | 11 (1) | 8 (0.7) | 8 (0.6) | 4 (0.2) | 11 (0.6) | 18 (0.9) | 11 (0.5) | 10 (0.4) | 7 (0.4) | 9 (0.4) | .0867 |
| Mean length of stay (days)* | 6.0 | 5.8 | 5.8 | 5.4 | 5.0 | 5.1 | 5.2 | 4.8 | 4.5 | 4.5 | <.0001 |
| Mean hospital charges ($)* | 58 471 | 67 195 | 68 064 | 79 665 | 87 668 | 94 318 | 95 511 | 109 121 | 102 248 | 111 235 | <.0001 |
a All data is from the Nationwide Inpatient Sample database and include patients between 80 and 89 years of age who underwent lumbar spinal fusion from 2004 to 2013. Data is expressed as a raw value with percentage of total fusions for that year in parentheses. Data from 2004 was compared with 2013 for a single category to determine statistical significance.
* Denotes a statistically significant change over time at P < .001.