PMID- 33009559
OWN - NLM
STAT- MEDLINE
DCOM- 20210413
LR  - 20210413
IS  - 1524-4040 (Electronic)
IS  - 0148-396X (Linking)
VI  - 88
IP  - 2
DP  - 2021 Jan 13
TI  - The Effect of Perioperative Adverse Events on Long-Term Patient-Reported Outcomes 
      After Lumbar Spine Surgery.
PG  - 420-427
LID - 10.1093/neuros/nyaa427 [doi]
AB  - BACKGROUND: Perioperative adverse events (AEs) lead to patient disappointment and 
      greater costs. There is a paucity of data on how AEs affect long-term outcomes. 
      OBJECTIVE: To examine perioperative AEs and their impact on outcome after lumbar 
      spine surgery. METHODS: A total of 3556 consecutive patients undergoing surgery 
      for lumbar degenerative disorders enrolled in the Canadian Spine Outcomes and 
      Research Network were analyzed. AEs were defined using the validated Spine 
      AdVerse Events Severity system. Outcomes at 3, 12, and 24 mo postoperatively 
      included the Owestry Disability Index (ODI), 12-Item Short-Form Health Survey 
      (SF-12) Physical (PCS) and Mental (MCS) Component Summary scales, visual analog 
      scale (VAS) leg and back, EuroQol-5D (EQ5D), and satisfaction. RESULTS: AEs 
      occurred in 767 (21.6%) patients, and 85 (2.4%) patients suffered major AEs. 
      Patients with major AEs had worse ODI scores and did not reach minimum clinically 
      important differences at 2 yr (no AE: 25.7 +/- 19.2, major: 36.4 +/- 19.1, P < .001). 
      Major AEs were associated with worse ODI scores on multivariable linear 
      regression (P = .011). PCS scores were lower after major AEs (43.8 +/- 9.5, vs 
      37.7 +/- 20.3, P = .002). On VAS leg and back and EQ5D, the 2-yr outcomes were 
      significantly different between the major and no AE groups (<0.01), but these 
      differences were small (VAS leg: 3.4 +/- 3.0 vs 4.0 +/- 3.3; VAS back: 3.5 +/- 2.7 vs 
      4.5 +/- 2.6; EQ5D: 0.75 +/- 0.2 vs 0.64 +/- 0.2). SF12 MCS scores were not different. 
      Rates of satisfaction were lower after major AEs (no AE: 84.6%, major: 72.3%, P 
      < .05). CONCLUSION: Major AEs after lumbar spine surgery lead to worse functional 
      outcomes and lower satisfaction. This highlights the need to implement strategies 
      aimed at reducing AEs.
CI  - Copyright (c) 2020 by the Congress of Neurological Surgeons.
FAU - Ayling, Oliver G S
AU  - Ayling OGS
AD  - Department of Surgery, Vancouver General Hospital/University of British Columbia, 
      Vancouver, Canada.
FAU - Ailon, Tamir
AU  - Ailon T
AD  - Department of Surgery, Vancouver General Hospital/University of British Columbia, 
      Vancouver, Canada.
FAU - Street, John T
AU  - Street JT
AD  - Department of Surgery, Vancouver General Hospital/University of British Columbia, 
      Vancouver, Canada.
FAU - Dea, Nicolas
AU  - Dea N
AD  - Department of Surgery, Vancouver General Hospital/University of British Columbia, 
      Vancouver, Canada.
FAU - McIntosh, Greg
AU  - McIntosh G
AD  - Canadian Spine Society, Markdale, Canada.
FAU - Abraham, Edward
AU  - Abraham E
AD  - Department of Surgery, Canada East Spine Centre, Saint John, Canada.
FAU - Jacobs, W Bradly
AU  - Jacobs WB
AD  - Department of Surgery, University of Calgary, Calgary, Canada.
FAU - Soroceanu, Alex
AU  - Soroceanu A
AD  - Department of Surgery, University of Calgary, Calgary, Canada.
FAU - Johnson, Michael G
AU  - Johnson MG
AD  - Departments of Orthopedics and Neurosurgery, University of Manitoba, Winnipeg, 
      Canada.
FAU - Paquet, Jerome
AU  - Paquet J
AD  - Department of Surgery, Laval University, Quebec City, Canada.
FAU - Rasoulinejad, Parham
AU  - Rasoulinejad P
AD  - Department of Surgery, University of Western Ontario, London, Canada.
FAU - Phan, Phillipe
AU  - Phan P
AD  - Department of Surgery, University of Ottawa, Ottawa, Canada.
FAU - Yee, Albert
AU  - Yee A
AD  - Department of Surgery, University of Toronto, Toronto, Canada.
FAU - Christie, Sean
AU  - Christie S
AD  - Department of Surgery, Dalhousie University, Halifax, Canada.
FAU - Nataraj, Andrew
AU  - Nataraj A
AD  - Department of Surgery, University of Alberta, Edmonton, Canada.
FAU - Glennie, R Andrew
AU  - Glennie RA
AD  - Department of Surgery, Dalhousie University, Halifax, Canada.
FAU - Hall, Hamilton
AU  - Hall H
AD  - Department of Surgery, University of Toronto, Toronto, Canada.
FAU - Manson, Neil
AU  - Manson N
AD  - Department of Surgery, Canada East Spine Centre, Saint John, Canada.
FAU - Rampersaud, Y Raja
AU  - Rampersaud YR
AD  - Department of Surgery, University of Toronto, Toronto, Canada.
FAU - Thomas, Kenneth
AU  - Thomas K
AD  - Department of Surgery, University of Calgary, Calgary, Canada.
FAU - Fisher, Charles G
AU  - Fisher CG
AD  - Department of Surgery, Vancouver General Hospital/University of British Columbia, 
      Vancouver, Canada.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Neurosurgery
JT  - Neurosurgery
JID - 7802914
SB  - IM
MH  - Adult
MH  - Aged
MH  - Canada
MH  - Disability Evaluation
MH  - Female
MH  - Humans
MH  - Lumbar Vertebrae/surgery
MH  - Male
MH  - Middle Aged
MH  - Neurosurgical Procedures/*adverse effects
MH  - Patient Reported Outcome Measures
MH  - Postoperative Complications/*epidemiology
MH  - Spinal Diseases/*surgery
MH  - *Treatment Outcome
OTO - NOTNLM
OT  - Adverse events
OT  - Complications
OT  - Patient-reported outcomes
OT  - Spine surgery
EDAT- 2020/10/04 06:00
MHDA- 2021/04/14 06:00
CRDT- 2020/10/03 05:32
PHST- 2019/10/26 00:00 [received]
PHST- 2020/06/28 00:00 [accepted]
PHST- 2020/10/04 06:00 [pubmed]
PHST- 2021/04/14 06:00 [medline]
PHST- 2020/10/03 05:32 [entrez]
AID - 5917482 [pii]
AID - 10.1093/neuros/nyaa427 [doi]
PST - ppublish
SO  - Neurosurgery. 2021 Jan 13;88(2):420-427. doi: 10.1093/neuros/nyaa427.