PMID- 25901976
OWN - NLM
STAT- MEDLINE
DCOM- 20160104
LR  - 20191210
IS  - 1528-1159 (Electronic)
IS  - 0362-2436 (Linking)
VI  - 40
IP  - 5
DP  - 2015 Mar 1
TI  - Adverse events in surgically treated cervical spondylopathic myelopathy: a 
      prospective validated observational study.
PG  - 292-8
LID - 10.1097/BRS.0000000000000755 [doi]
AB  - STUDY DESIGN: Prospective observational study. OBJECTIVE: Using validated tools 
      to accurately identify and quantify incidence of and risks for inpatient adverse 
      events (AEs) associated with surgical management of cervical spondylopathic 
      myelopathy (CSM) with the goal of assisting physicians and patients in decision 
      making. To identify patient-/disease-/technique-specific, independent risk 
      factors for developing AEs perioperatively and affecting length of stay for 
      patients treated surgically for CSM. SUMMARY OF BACKGROUND DATA: Previous studies 
      have reported an overall perioperative complication rate between 15.6% and 
      18.52%. METHODS: A total of 104 patients underwent surgery for CSM in our 
      academic quaternary referral center. The average age was 60.3 years (range, 34-86 
      yr) with a male preponderance (n = 77, 74%). The severity of myelopathy and 
      significant comorbidities was measured and was in keeping with previously 
      assessed populations. Surgical approach was anterior-alone (39.4%), 
      posterior-alone (55.8%), or combined (4.8%) surgery. Inpatient AE data were 
      collected in a rigorous, contemporaneous fashion using the previously validated 
      Spine Adverse Events Severity System (SAVES) tool. RESULTS: A total AE rate of 
      42.3% was documented in surgically managed patients with CSM (intraoperative = 
      13.5%, postoperative = 37.5%). Statistically significant risk factors for 
      postoperative AEs were identified, including number of comorbidities (P = 0.012), 
      anterior surgical approach (P = 0.003), and number of levels operated on (P = 
      0.031). Multiple risk factors for length of stay were also identified, including 
      number of AEs (P < 0.0001), Nurick Score (P < 0.0001), number of levels operated 
      on (P = 0.006), and occurrence of deep wound infection (P < 0.0001). CONCLUSION: 
      We report higher perioperative AE rates than previously recognized, due to the 
      use of a validated, rigorous data collection tool. Multiple novel patient/disease 
      severity/surgical factors with high statistical significance on perioperative AEs 
      have been identified. LEVEL OF EVIDENCE: 3.
FAU - Hartig, Dennis
AU  - Hartig D
AD  - *Vancouver General Hospital, Combined Neurosurgical and Orthopaedic Spine 
      Program, Vancouver, Canada daggerDepartment of Orthopaedics, Division of Spine, 
      University of British Columbia, Vancouver, Canada; and double daggerOrthopaedic Department, 
      Royal Brisbane Hospital, Brisbane, Queensland, Australia.
FAU - Batke, Juliet
AU  - Batke J
FAU - Dea, Nicolas
AU  - Dea N
FAU - Kelly, Adrienne
AU  - Kelly A
FAU - Fisher, Charles
AU  - Fisher C
FAU - Street, John
AU  - Street J
LA  - eng
PT  - Journal Article
PT  - Observational Study
PT  - Validation Study
PL  - United States
TA  - Spine (Phila Pa 1976)
JT  - Spine
JID - 7610646
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Cervical Vertebrae/pathology/surgery
MH  - Decompression, Surgical/*adverse effects
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Postoperative Complications/diagnosis/*etiology
MH  - Prospective Studies
MH  - Spinal Cord Diseases/diagnosis/*surgery
MH  - Spondylosis/diagnosis/*surgery
MH  - Treatment Outcome
EDAT- 2015/04/23 06:00
MHDA- 2016/01/05 06:00
CRDT- 2015/04/23 06:00
PHST- 2015/04/23 06:00 [entrez]
PHST- 2015/04/23 06:00 [pubmed]
PHST- 2016/01/05 06:00 [medline]
AID - 00007632-201503010-00005 [pii]
AID - 10.1097/BRS.0000000000000755 [doi]
PST - ppublish
SO  - Spine (Phila Pa 1976). 2015 Mar 1;40(5):292-8. doi: 10.1097/BRS.0000000000000755.