PMID- 26456809
OWN - NLM
STAT- MEDLINE
DCOM- 20161012
LR  - 20220311
IS  - 1878-1632 (Electronic)
IS  - 1529-9430 (Linking)
VI  - 16
IP  - 2
DP  - 2016 Feb
TI  - Morbidity and mortality of complex spine surgery: a prospective cohort study in 
      679 patients validating the Spine AdVerse Event Severity (SAVES) system in a 
      European population.
PG  - 146-53
LID - S1529-9430(15)01497-7 [pii]
LID - 10.1016/j.spinee.2015.09.051 [doi]
AB  - BACKGROUND CONTEXT: Most literature on complications in spine surgery has been 
      retrospective or based on national databases with few variables. The Spine 
      AdVerse Events Severity (SAVES) system has been found reliable and valid in two 
      Canadian centers, providing precise information regarding all adverse events 
      (AEs). PURPOSE: This study aimed to determine the mortality and examine the 
      incidence of morbidity in patients undergoing complex spinal surgery, including 
      pediatric patients, and to validate the SAVES system in a European population. 
      STUDY DESIGN: A prospective, consecutive cohort study was conducted using the 
      SAVES version 2010 in the period from January 1, 2013 until December 31, 2013. A 
      retrospective analysis was performed on all patients operated from November 1, 
      2011 until October 31, 2012 for comparison. PATIENT SAMPLE: Patients undergoing 
      spinal surgery at a tertiary referral center comprised the patient sample. 
      OUTCOME MEASURES: Morbidity and mortality were determined according to the newest 
      version of the SAVES system and compared with the Canadian cohort. Other outcomes 
      were length of stay, readmission, unplanned second surgery during index 
      admission, as well as wound infections requiring revision. METHODS: All patients 
      undergoing spinal surgery at an academic tertiary referral center in the study 
      period were prospectively included. The newest version of SAVES system was used, 
      and a research coordinator collected all intraoperative and perioperative data 
      prospectively. Once a week all patients were reviewed for additional events, 
      validation of the data, and clarification of any questions. Patients were grouped 
      according to the type of admission (elective of emergency) and age, and 
      subgrouped according to a major diagnostic group. The survival status was 
      registered on January 31, 2014 to obtain 30-day survival. RESULTS: A total of 679 
      consecutive cases were included with 100% data completion. The in-hospital 
      mortality was 1.3% and the 30-day mortality was 2.7%; all occurring after 
      emergency procedures. The number of intraoperative AEs was 162 (overall incidence 
      20%), and the number of postoperative AEs was 1,415 (overall incidence 77%). Of 
      the patients, 2.2% had postoperative infections requiring surgical revision. 
      CONCLUSIONS: A prospective registration improves AE recognition, and our data 
      confirm the generalizability of the SAVES system to pediatric and non-Canadian 
      populations.
CI  - Copyright (c) 2015 Elsevier Inc. All rights reserved.
FAU - Karstensen, Sven
AU  - Karstensen S
AD  - Spine Unit, Department of Orthopaedic Surgery, Rigshospitalet, University of 
      Copenhagen, 9 Blegdamsvej, 2100 Copenhagen, Denmark. Electronic address: 
      svenhka@gmail.com.
FAU - Bari, Tanvir
AU  - Bari T
AD  - Spine Unit, Department of Orthopaedic Surgery, Rigshospitalet, University of 
      Copenhagen, 9 Blegdamsvej, 2100 Copenhagen, Denmark.
FAU - Gehrchen, Martin
AU  - Gehrchen M
AD  - Spine Unit, Department of Orthopaedic Surgery, Rigshospitalet, University of 
      Copenhagen, 9 Blegdamsvej, 2100 Copenhagen, Denmark.
FAU - Street, John
AU  - Street J
AD  - Combined Neurosurgical and Orthopedic Spine Program, Vancouver General Hospital, 
      University of British Columbia, Floor 6, Blusson Spinal Cord Center, 818 West 
      10th Ave., Vancouver, British Columbia V5Z 1M9, Canada.
FAU - Dahl, Benny
AU  - Dahl B
AD  - Spine Unit, Department of Orthopaedic Surgery, Rigshospitalet, University of 
      Copenhagen, 9 Blegdamsvej, 2100 Copenhagen, Denmark.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Validation Study
DEP - 20151008
PL  - United States
TA  - Spine J
JT  - The spine journal : official journal of the North American Spine Society
JID - 101130732
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Child
MH  - Child, Preschool
MH  - Europe
MH  - Female
MH  - Hospital Mortality
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Neurosurgical Procedures/*adverse effects
MH  - Postoperative Complications/mortality/*pathology
MH  - Prospective Studies
MH  - Retrospective Studies
MH  - Spine/*surgery
MH  - *Trauma Severity Indices
OTO - NOTNLM
OT  - Adverse events
OT  - Cohort
OT  - Complex
OT  - Complications
OT  - Morbidity
OT  - Prospective
EDAT- 2015/10/13 06:00
MHDA- 2016/10/13 06:00
CRDT- 2015/10/13 06:00
PHST- 2015/01/10 00:00 [received]
PHST- 2015/08/20 00:00 [revised]
PHST- 2015/09/28 00:00 [accepted]
PHST- 2015/10/13 06:00 [entrez]
PHST- 2015/10/13 06:00 [pubmed]
PHST- 2016/10/13 06:00 [medline]
AID - S1529-9430(15)01497-7 [pii]
AID - 10.1016/j.spinee.2015.09.051 [doi]
PST - ppublish
SO  - Spine J. 2016 Feb;16(2):146-53. doi: 10.1016/j.spinee.2015.09.051. Epub 2015 Oct 
      8.