TY - JOUR
T1 - Timing of Complications Occurring Within 30 Days After Adult Spinal Deformity Surgery
AU - De la Garza Ramos, Rafael
AU - Goodwin, C. Rory
AU - Passias, Peter G.
AU - Neuman, Brian J.
AU - Kebaish, Khaled M.
AU - Lafage, Virginie
AU - Schwab, Frank
AU - Sciubba, Daniel M.
N1 - Funding Information:
RDGR (none); CRG (is a UNCF Merck Postdoctoral Fellow and has received an award from the Burroughs Wellcome Fund and the Johns Hopkins Neurosurgery Pain Research Institute); PGP (none); BJN (none); KMK (none); VL (none); FS (none); DMS (consulting relationships with Medtronic, Globus, DePuy-Synthes, and Orthofix).
Publisher Copyright:
© 2016 Scoliosis Research Society
PY - 2017/3/1
Y1 - 2017/3/1
N2 - 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.
AB - 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.
KW - Adult spinal deformity
KW - Complications
KW - National Surgical Quality Improvement database
KW - Spinal fusion
KW - Timing
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U2 - 10.1016/j.jspd.2016.10.009
DO - 10.1016/j.jspd.2016.10.009
M3 - Article
C2 - 28259267
AN - SCOPUS:85014065549
SN - 2212-134X
VL - 5
SP - 145
EP - 150
JO - Spine deformity
JF - Spine deformity
IS - 2
ER -