The predictive ability of ECI and CCI have been compared in orthopaedic and gastrointestinal surgery, however their predictive ability for complications secondary to spine surgery and posterior cervical decompression and fusion (PCDF) specifically is understudied. This study examines the predictive ability of the Elixhauser Comorbidity Index (ECI) and Charlson Comorbidity Index (CCI) for complications and morbidity following PCDF.
ECI and CCI were retrospectively computed for all PCDF cases in the National Inpatient Sample database from 2013 to 2014 and complications or morbidity were identified. C-statistics were used to analyze ECI and CCI predictive ability in a range of complications and compared to a base comorbidity model that included age, sex, race, and primary payer.
PCDF was performed in 46,700 hospitalizations between 2013 and 2014. The complications for which ECI was found to be a significantly better predictor included airway complications (69.16% superior to CCI), hemorrhagic anemia (79.04% superior), cardiac arrest (72.39% superior), pulmonary embolism (83.01% superior), sepsis (62.44% superior), septic shock (78.90% superior), UTI (63.53% superior), death (74.28% superior), any minor complication (75% superior), any major complication (133% superior), and any complication at all (63.72% superior). The complications for which neither the ECI Index nor the CCI proved superior were acute kidney injury, myocardial infarction, cerebrovascular accident, deep vein thrombosis, pneumonia, wound dehiscence, and superficial surgical site infection following PCDF.
ECI showed superior predictive ability to the CCI in predicting 8 of the 18 complications that were analyzed and inferior in none.

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