Table 2 Incidence of stroke in patients undergoing elective posterior lumbar fusion during various risk windows
Stroke incidence type | During index hospitalization | Up to 30 days post-operation | Up to 90 days post-operation | Up to 180 days post-operation | Up to 365 days post-operation | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Number of patients at risk | Number of cases | Years at risk | Incidence proportion(95% confidence interval) | Number of patients at risk | Number of cases | Years at risk | Incidence proportion(95% confidence interval) | Number of patients at risk | Number of cases | Years at risk | Incidence proportion(95% confidence interval) | Number of patients at risk | Number of cases | Years at risk | Incidence proportion(95% confidence interval) | Number of patients at risk | Number of cases | Years at risk | Incidence proportion(95% confidence interval) | |
Crude | 42,742 | 126 | 550.03 | 0.29% (0.25, 0.35%) | 42,744 | 186 | 3523.41 | 0.44% (0.38, 0.50%) | 42,745 | 252 | 9833.32 | 0.59% (0.52, 0.67%) | 42,746 | 327 | 18,712.01 | 0.76% (0.68, 0.85%) | 42,750 | 480 | 35,079.03 | 1.12% (1.03, 1.23%) |
Stratifications by: | ||||||||||||||||||||
Age (years) | ||||||||||||||||||||
≥ 18–55 | 15,181 | 17 | 179.62 | 0.11% (0.07, 0.18%) | 15,181 | 25 | 1251.95 | 0.16% (0.11, 0.24%) | 15,181 | 36 | 3498.67 | 0.24% (0.17, 0.33%) | 15,181 | 44 | 6673.80 | 0.29% (0.21, 0.39%) | 15,181 | 61 | 12,537.16 | 0.40% (0.31, 0.52%) |
56–65 | 11,588 | 22 | 146.04 | 0.19% (0.12, 0.29%) | 11,590 | 39 | 956.04 | 0.34% (0.24, 0.46%) | 11,591 | 53 | 2662.86 | 0.46% (0.34, 0.60%) | 11,591 | 70 | 5058.52 | 0.60% (0.47, 0.76%) | 11,593 | 105 | 9446.15 | 0.91% (0.74, 1.10%) |
66–75 | 11,438 | 51 | 157.62 | 0.45% (0.33, 0.59%) | 11,438 | 71 | 942.84 | 0.62% (0.49, 0.78%) | 11,438 | 90 | 2634.55 | 0.79% (0.63, 0.97%) | 11,438 | 127 | 5009.82 | 1.11% (0.93, 1.32%) | 11,440 | 190 | 9383.93 | 1.66% (1.43, 1.91%) |
76 - < 86 | 4535 | 36 | 66.74 | 0.79% (0.56, 1.10%) | 4535 | 51 | 372.57 | 1.12% (0.84, 1.48%) | 4535 | 73 | 1037.24 | 1.61% (1.26, 2.02%) | 4536 | 86 | 1969.88 | 1.90% (1.52, 2.34%) | 4536 | 124 | 3711.79 | 2.73% (2.28, 3.25%) |
Sex | ||||||||||||||||||||
Male | 20,404 | 64 | 256.25 | 0.31% (0.24, 0.40%) | 20,405 | 96 | 1680.10 | 0.47% (0.38, 0.57%) | 20,405 | 129 | 4681.68 | 0.63% (0.53, 0.75%) | 20,406 | 175 | 8898.68 | 0.86% (0.74, 0.99%) | 20,409 | 258 | 16,640.24 | 1.26% (1.12, 1.43%) |
Female | 22,325 | 62 | 293.61 | 0.28% (0.21, 0.36%) | 22,326 | 90 | 1842.21 | 0.40% (0.32, 0.50%) | 22,327 | 123 | 5148.73 | 0.55% (0.46, 0.66%) | 22,327 | 152 | 9807.71 | 0.68% (0.58, 0.80%) | 22,328 | 222 | 18,427.89 | 0.99% (0.87, 1.13%) |
Unknown | 13 | 0 | 0.17 | 0.00% (0.00, 0.00%) | 13 | 0 | 1.10 | 0.00% (0.00, 0.00%) | 13 | 0 | 2.91 | 0.00% (0.00, 0.00%) | 13 | 0 | 5.62 | 0.00% (0.00, 0.00%) | 13 | 0 | 10.90 | 0.00% (0.00, 0.00%) |
Race | ||||||||||||||||||||
White | 38,246 | 113 | 487.13 | 0.30% (0.24, 0.36%) | 38,248 | 160 | 3154.63 | 0.42% (0.36, 0.49%) | 38,249 | 218 | 8814.21 | 0.57% (0.50, 0.65%) | 38,250 | 286 | 16,787.98 | 0.75% (0.66, 0.84%) | 38,254 | 419 | 31,522.14 | 1.10% (0.99, 1.20%) |
Black or African American | 2545 | 9 | 36.89 | 0.35% (0.16, 0.67%) | 2545 | 17 | 210.81 | 0.67% (0.39, 1.07%) | 2545 | 23 | 585.70 | 0.90% (0.57, 1.35%) | 2545 | 28 | 1108.84 | 1.10% (0.73, 1.59%) | 2545 | 42 | 2063.04 | 1.65% (1.19, 2.22%) |
Asian | 212 | 0 | 3.33 | 0.00% (0.00, 0.00%) | 212 | 0 | 17.43 | 0.00% (0.00, 0.00%) | 212 | 1 | 49.07 | 0.47% (0.01, 2.60%) | 212 | 2 | 93.98 | 0.94% (0.11, 3.37%) | 212 | 3 | 172.13 | 1.42% (0.29, 4.08%) |
Other/Unknown | 1739 | 4 | 22.68 | 0.23% (0.06, 0.59%) | 1739 | 9 | 140.54 | 0.52% (0.24, 0.98%) | 1739 | 10 | 384.34 | 0.58% (0.28, 1.06%) | 1739 | 11 | 721.21 | 0.63% (0.32, 1.13%) | 1739 | 16 | 1321.71 | 0.92% (0.53, 1.49%) |
Type 1 Diabetes during baseline | ||||||||||||||||||||
Yes | 270 | 1 | 3.85 | 0.37% (0.01, 2.05%) | 270 | 2 | 22.56 | 0.74% (0.09, 2.65%) | 271 | 3 | 64.50 | 1.11% (0.23, 3.20%) | 271 | 4 | 123.85 | 1.48% (0.40, 3.74%) | 271 | 9 | 231.14 | 3.32% (1.53, 6.21%) |
No | 42,472 | 125 | 546.17 | 0.29% (0.25, 0.35%) | 42,474 | 184 | 3500.85 | 0.43% (0.37, 0.50%) | 42,474 | 249 | 9768.82 | 0.59% (0.52, 0.66%) | 42,475 | 323 | 18,588.16 | 0.76% (0.68, 0.85%) | 42,479 | 471 | 34,847.88 | 1.11% (1.01, 1.21%) |
Type 2 Diabetes during baseline | ||||||||||||||||||||
Yes | 5923 | 23 | 82.24 | 0.39% (0.25, 0.58%) | 5923 | 42 | 492.66 | 0.71% (0.51, 0.96%) | 5924 | 58 | 1394.58 | 0.98% (0.74, 1.26%) | 5924 | 81 | 2672.70 | 1.37% (1.09, 1.70%) | 5926 | 123 | 5026.02 | 2.08% (1.73, 2.47%) |
No | 36,819 | 103 | 467.78 | 0.28% (0.23, 0.34%) | 36,821 | 144 | 3030.75 | 0.39% (0.33, 0.46%) | 36,821 | 194 | 8438.74 | 0.53% (0.46, 0.61%) | 36,822 | 246 | 16,039.31 | 0.67% (0.59, 0.76%) | 36,824 | 357 | 30,053.01 | 0.97% (0.87, 1.07%) |
Existing permanently implanted device or prosthesis at baseline | ||||||||||||||||||||
Yes | 1242 | 0 | 17.80 | 0.00% (0.00, 0.00%) | 1242 | 1 | 102.71 | 0.08% (0.00, 0.45%) | 1242 | 1 | 287.33 | 0.08% (0.00, 0.45%) | 1242 | 4 | 547.00 | 0.32% (0.09, 0.82%) | 1242 | 8 | 1019.47 | 0.64% (0.28, 1.27%) |
No | 41,500 | 126 | 532.23 | 0.30% (0.25, 0.36%) | 41,502 | 185 | 3420.70 | 0.45% (0.38, 0.51%) | 41,503 | 251 | 9545.98 | 0.60% (0.53, 0.68%) | 41,504 | 323 | 18,165.01 | 0.78% (0.70, 0.87%) | 41,508 | 472 | 34,059.56 | 1.14% (1.04, 1.24%) |
Total length of hospital stay | ||||||||||||||||||||
1–5 days | 37,077 | 60 | 393.57 | 0.16% (0.12, 0.21%) | 37,079 | 104 | 3053.66 | 0.28% (0.23, 0.34%) | 37,080 | 148 | 8514.74 | 0.40% (0.34, 0.47%) | 37,081 | 209 | 16,198.14 | 0.56% (0.49, 0.65%) | 37,084 | 336 | 30,364.03 | 0.91% (0.81, 1.01%) |
6–10 days | 4530 | 43 | 98.86 | 0.95% (0.69, 1.28%) | 4530 | 57 | 375.63 | 1.26% (0.95, 1.63%) | 4530 | 70 | 1054.52 | 1.55% (1.21, 1.95%) | 4530 | 80 | 2012.51 | 1.77% (1.40, 2.19%) | 4530 | 99 | 3774.44 | 2.19% (1.78, 2.65%) |
> 10 days | 1135 | 23 | 57.60 | 2.03% (1.29, 3.03%) | 1135 | 25 | 94.11 | 2.20% (1.43, 3.23%) | 1135 | 34 | 264.06 | 3.00% (2.08, 4.16%) | 1135 | 38 | 501.35 | 3.35% (2.38, 4.57%) | 1136 | 45 | 940.55 | 3.96% (2.90, 5.26%) |
Use of implanted material during surgery on the same day as index surgery | ||||||||||||||||||||
Yes | 3095 | 11 | 44.45 | 0.36% (0.18, 0.64%) | 3095 | 16 | 255.45 | 0.52% (0.30, 0.84%) | 3095 | 19 | 714.26 | 0.61% (0.37, 0.96%) | 3095 | 32 | 1373.09 | 1.03% (0.71, 1.46%) | 3095 | 44 | 2626.26 | 1.42% (1.03, 1.90%) |
No | 39,647 | 115 | 505.58 | 0.29% (0.24, 0.35%) | 39,649 | 170 | 3267.96 | 0.43% (0.37, 0.50%) | 39,650 | 233 | 9119.06 | 0.59% (0.51, 0.67%) | 39,651 | 295 | 17,338.92 | 0.74% (0.66, 0.83%) | 39,655 | 436 | 32,452.77 | 1.10% (1.00, 1.21%) |
Medical history of stroke | ||||||||||||||||||||
Yes | 291 | 39 | 4.59 | 13.40% (9.71, 17.86%) | 292 | 58 | 20.47 | 19.86% (15.44, 24.91%) | 292 | 77 | 54.44 | 26.37% (21.41, 31.82%) | 292 | 84 | 100.04 | 28.77% (23.64, 34.33%) | 292 | 106 | 177.45 | 36.30% (30.78, 42.11%) |
No | 42,451 | 87 | 545.43 | 0.20% (0.16, 0.25%) | 42,452 | 128 | 3502.94 | 0.30% (0.25, 0.36%) | 42,453 | 175 | 9778.87 | 0.41% (0.35, 0.48%) | 42,454 | 243 | 18,611.98 | 0.57% (0.50, 0.65%) | 42,458 | 374 | 34,901.58 | 0.88% (0.79, 0.97%) |