Timing of Complications Occurring Within 30 Days After Adult Spinal Deformity Surgery

Rafael De la Garza Ramos, C. Rory Goodwin, Peter G. Passias, Brian J. Neuman, Khaled M. Kebaish, Virginie Lafage, Frank Schwab, Daniel M. Sciubba

Research output: Contribution to journalArticle

Abstract

Study Design Cross-sectional study of a national surgical database. Objective To investigate the timing of complications after adult spinal deformity (ASD) surgery. Summary of Background Data There is limited data on the range of days when complications after ASD surgery occur. Methods The American College of Surgeons National Surgical Quality Improvement database was reviewed for the years 2007–2013. Inclusion criteria were adult patients (over 21 years of age) who underwent spinal fusion for ASD. Ten unique complications occurring within 30 postoperative days were examined and the median day to diagnosis was recorded. Results A total of 1,250 patients met inclusion criteria with an overall complication rate of 13.5%. The median day of diagnosis (and interquartile range) for each complication was as follows: myocardial infarction (3.5, 1–5), pulmonary embolism (4, 2–16), reintubation (4.5, 1–11), pneumonia (6, 3–9), urinary tract infection (11, 5–15), sepsis (12, 6–18.5), deep vein thrombosis (12, 6–19), deep surgical site infection (SSI; 18.5, 13–23), superficial SSI (19, 13–24), and organ space SSI (21, 17–25). The three complications that were most commonly diagnosed before hospital discharge included pneumonia, reintubation, and myocardial infarction (diagnosed before discharge on more than 70% of cases). On the other hand, superficial, deep, and organ space infection were diagnosed in less than 40% of cases before patients left the hospital. On univariate analysis, predictors of complication occurrence included older age (p = .014), instrumentation of 7–12 levels (p = .034), and instrumentation of 13 or more levels (p = .035). Conclusion Understanding the timing of specific complications after adult spinal deformity surgery is important for both patients and clinicians. Efforts in prevention of such conditions should continue, as well as heightened awareness during the periods of highest risk.

Original languageEnglish (US)
Pages (from-to)145-150
Number of pages6
JournalSpine deformity
Volume5
Issue number2
DOIs
StatePublished - Mar 1 2017

Keywords

  • Adult spinal deformity
  • Complications
  • National Surgical Quality Improvement database
  • Spinal fusion
  • Timing

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine

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