Risk Factors Associated with 30-Day Mortality After Open Reduction and Internal Fixation of Vertebral Fractures

Ivan B. Ye, Steven J. Girdler, Zoe B. Cheung, Samuel J. White, William A. Ranson, Samuel Kang Wook Cho

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1 Scopus citations


Objective: Few studies have examined the outcomes of open reduction and internal fixation of vertebral fractures. The purpose of this study was to determine patient-related and surgery-related risk factors associated with 30-day postoperative mortality after open reduction and internal fixation (ORIF) of cervical, thoracic, and lumbar vertebral fractures. Methods: This was a retrospective cohort study of data from the 2010–2014 ACS-NSQIP database. Adult patients who underwent ORIF of vertebral fractures in the cervical, thoracic, or lumbar spine were included. Patients were divided into 2 groups on the basis of the occurrence of 30-day postoperative mortality. A univariate analysis was performed to compare baseline patient characteristics, comorbidities, operative variables, and 30-day postoperative complications between the mortality and nonmortality groups. A subsequent multivariate regression analysis adjusting for patient and operative factors was then performed to identify independent risk factors for 30-day mortality. Results: A total of 900 patients who underwent vertebral ORIF were included. The overall 30-day postoperative mortality rate was 1.56%. The mortality group had a higher incidence of pneumonia, pulmonary complications, cardiac complications, blood transfusion, sepsis, and prolonged hospitalization. Multivariate regression analysis identified pulmonary comorbidity and diabetes as independent predictors of 30-day mortality following ORIF of vertebral fractures. Conclusions: Pulmonary comorbidity and diabetes were found to be independent risk factors for 30-day mortality after ORIF of vertebral fractures. Recognizing these risk factors is important in preoperative risk stratification, perioperative care, and patient counseling.

Original languageEnglish
Pages (from-to)e1069-e1073
JournalWorld Neurosurgery
StatePublished - May 2019


  • Complication
  • Fixation
  • Mortality
  • ORIF
  • Open reduction internal fixation
  • Spinal fracture
  • Vertebral fracture


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