Risk factors of pulmonary complications after minimally invasive surgery for elderly patients with vertebral compression fractures

Purpose: To determine the risk factors for pulmonary complications after minimally invasive surgery in elderly patients with vertebral compression fractures (VCFs). Methods: We retrospectively analyzed 233 elderly patients (age ≥ 65 years) with VCFs who underwent percutaneous vertebroplasty (PVP) or percutaneous kyphoplasty (PKP) surgery at Hebei General Hospital from January 2011 to December 2016 . Risk factors and the effects of the model were determined by univariate logistic regression analyses and the receiver operating characteristic (ROC) curve, respectively. A risk assessment scale was established based on the risk factors and physiological and surgical scores for mortality and morbidity. The risk assessment scale prospectively evaluated risk factors of pulmonary complications after minimally invasive surgery for elderly patients with VCFs from January to June 2017. Results: A total of 27 patients diagnosed with pulmonary complications (11.59%) among 233 detected patients. There were statistically significant differences in age, body mass index (BMI), smoking, cardiovascular diseases and old fractures between patients with and without pulmonary complications (P<0.05). Logistic regression analysis showed that smoking, cardiovascular diseases and old fractures were risk factors of pulmonary complications after PVP or PKP for elderly patients with VCFs (P<0.05) and area under the curve was 0.738 (95% confidence intervals (CI): 0.648-0.828). We assessed 53 elderly patients with VCFs, 5 of whom occurred pulmonary complications after PVP or PKP. Areas under the curve of preoperative and total risk assessment values were all 0.925. Conclusions: Significant risk factors of pulmonary complications were BMI, cardiovascular diseases and old fractures for patients aged 65 years or elderly with VCFs after minimally invasive surgery. The risk assessment scale established by us gaining high accuracy.