Long-Term Impact of Gastrointestinal Risk Stratification Management on Perioperative Digestive Complications in Elderly OVF Patients: A 10-Year Interrupted Time Series Study

Objective : To evaluate the long-term effect of gastrointestinal risk stratification management on the incidence and trend of perioperative digestive complications in elderly patients with osteoporotic vertebral fracture (OVF). Methods : Data from 4535 elderly OVF patients between 2015 and 2025 were retrospectively analyzed. To evaluate the impact of gastrointestinal risk stratification management, an interrupted time series analysis was performed to compare the incidence rates of total, functional, and organic digestive complications before and after the intervention. Subgroup analyses were carried out as well. Results : Based on multivariable regression analysis, for total complications, the incidence showed a significant increasing trend (β₁ = 0.0061, p<0.001) before intervention, and an immediate decrease by 19.12% (β₂ =-0.1912，p<0.001) after intervention, with an additional quarterly decline of 1.02% (β₃ = -0.0102，p<0.001), and the average incidence dropping from 17.74 % to 5.92 %. For organic complications, there was a significant pre-intervention increase (β₁ = 0.0011, p<0.001); post-intervention, an immediate reduction of 3.36% was observed (β₂ = -0.0336, p<0.001), followed by a continuous quarterly decrease of 0.17% (β₃ = -0.0017, p<0.001), with the average incidence declining from 3.23% to 1.66%. For functional complications, significant pre-intervention trend (β₁ = 0.0050 , p<0.001) was observed, but the incidence decreased immediately by 15.76% (β₂ = -0.1576, p<0.001) after intervention, with a sustained quarterly reduction of 0.85% (β₃ = -0.0085, p<0.001), and the average incidence falling from 14.51% to 4.26%. Subgroup analyses indicated that Age was not an independent risk factor for the overall complication rate (all P > 0.05), whereas the proportion of patients at high risk or above was identified as an independent risk factor for this outcome (P = 0.035). Conclusion : Gastrointestinal risk stratification management significantly reduced the incidence of perioperative digestive complications in elderly OVF patients, demonstrating both immediate and sustained effects, with particularly notable improvement for functional complications. Patient age was not an independent risk factor, whereas the proportion of high-risk or above patients was an independent risk factor.