Analysis of risk factors for prolonged length of stay of patients with thoracolumbar burst fractures
FAN Ze-juan
LIU Hui-zhen
CHEN Qi
SHA Yu-shan
Abstract：Objective To analyze risk factors for prolonged length of stay(LOS)in patients with thoracolumbar burst fractures.Methods Retrospective analysis of the preoperative clinical data of 224 patients with thoracolumbar burst fractures who underwent long-segment endoprosthetic fixation between March 2019 and June 2023 at our hospital was applied.LOS greater than or equal to the 75th percentile was prolonged LOS.Independent risk factors for prolonged LOS in patients with thoracolumbar burst fractures were analyzed using thoracic and lumbar Logistic regression modelling.Diagnostic performance was assessed using combined receiver operating characteristic(ROC)curves.Results The mean LOS of 224 patients with thoracolumbar burst fractures was(10.25±4.01)d.64 patients(28.6%)had prolonged LOS(>12 d).Age[(52.41±12.58)years vs.(48.65±11.87)years],BMI-lean(13.1%vs.7.2%)and obese(15.1%vs.6.8%),American Society of Anaesthesiologists(ASA)score(3-4)(25.0%vs.6.8%),deep vein thrombosis(DVT)(9.4%vs.2.5%),triglycerides(TG)(>1.7 mmol/L)(34.4%vs.19.4%),white blood cells(WBC)(>10×109/L)(26.6%vs.11.3%),C-reactive protein(CRP)(>10 mg/L)(34.4%vs.17.5%),platelet distribution width(PDW)(>12%)(20.3%vs.7.5%),lymphocyte(LYM)(<1.1×109/L)(20.3%vs.10.0%),and ALB(<35 g/L)(35.9%vs.20.6%)ratios of prolonged LOS were higher than those of the conventional LOS(P<0.05).Conclusions BMI-lean and obese,ASA score(3-4),diabetes,CRP(>10 mg/L),CRP(>10 mg/L),and ALB(<35 g/L)were associated with the risk of prolonged LOS for patients with thoracolumbar burst fractures,and the combination of these metrics had a very high predictive accuracy.BMI-lean and obese,ASA score(3-4),diabetes mellitus,CRP(>10 mg/L),and ALB(<35 g/L)independently increased the risk of delayed LOS in patients(P<0.05).The area under the cure(AUC)for the combined ROC of BMI,ASA score,diabetes mellitus,CRP,and ALB was 0.842(0.787-0.887).Conclusions BMI-lean and obese,ASA score(3-4),diabetes mellitus,CRP(>10 mg/L),CRP(>10 mg/L),and ALB(<35 g/L)were associated with the risk of prolonged LOS in patients with thoracolumbar burst fracture and the combination of these metrics indicates a high predictive accuracy for prolonged LOS risk.
Keywords：Spinal fracturesThoracic vertebraeLumbar vertebraeLength of stayRisk factors
Publication Date：2024-07-19
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 572-576 )