The results indicate
that the risk of such deaths is particularly high in young and
middle-aged workers with degenerative disc disease.
To examine complications
after lumbar fusion surgery, lead author Dr. Sham Maghout Juratli from
the University of Washington, Seattle, and colleagues analyzed workers'
compensation claims filed by lumbar fusion patients in Washington State
from 1994 to 2001. Washington State vital statistics records were used
to assess mortality through 2004.
Data from 2378 patients
were included in the analysis. The mortality rate at 90 days was 0.29%,
the authors note. Over 3 years, 103 patients died, for a 3-year
cumulative mortality rate of 1.93%.
Repeat fusions were
found to predict perioperative mortality.
After adjusting for age
and gender, 3.1 deaths occurred per 1000 worker-years.
There were 22
analgesic-associated deaths (19 accidental poisonings, 3 suicides).
These accounted for 21% of all deaths and for 31.4% of all potential
Use of cage devices for
fusion and the presence of degenerative disc disease were both risk
factors for analgesic-related death. In subjects between 45 and 54 years
of age, degenerative disc disease increased the odds of
analgesic-related death by 7.45-fold (p = 0.01).
"The most important
finding of this study was that analgesic-related deaths, both suicidal
and accidental, claimed the highest potential life lost (31.4%), more
than heart disease (9.2%), cancer (9.1%), and liver disease (5.1%),
combined," the investigators conclude."