PMID- 36624233 OWN - NLM STAT- MEDLINE DCOM- 20230314 LR - 20230326 IS - 0942-0940 (Electronic) IS - 0001-6268 (Print) IS - 0001-6268 (Linking) VI - 165 IP - 3 DP - 2023 Mar TI - Adverse events in neurosurgery: a comprehensive single-center analysis of a prospectively compiled database. PG - 585-593 LID - 10.1007/s00701-022-05462-w [doi] AB - PURPOSE: To prospectively identify and quantify neurosurgical adverse events (AEs) in a tertiary care hospital. METHODS: From January 2021 to December 2021, all patients treated in our department received a peer-reviewed AE-evaluation form at discharge. An AE was defined as any event after surgery that resulted in an undesirable clinical outcome, which is not caused by the underlying disease, that prolonged patient stay, resulted in readmission, caused a new neurological deficit, required revision surgery or life-saving intervention, or contributed to death. We considered AEs occurring within 30 days after discharge. AEs were categorized in wound event, cerebrospinal fluid (CSF) event, CSF shunt malfunction, post-operative infection, malpositioning of implanted material, new neurological deficit, rebleeding, and surgical goal not achieved and non-neurosurgical AEs. RESULTS: 2874 patients were included. Most procedures were cranial (45.1%), followed by spinal (33.9%), subdural (7.7%), CSF (7.0%), neuromodulation (4.0%), and other (2.3%). In total, there were 621 AEs shared by 532 patients (18.5%). 80 (2.8%) patients had multiple AEs. Most AEs were non-neurosurgical (222; 8.1%). There were 172 (6%) revision surgeries. Patients receiving cranial interventions had the most AEs (19.1%) although revision surgery was only necessary in 3.1% of patients. Subdural interventions had the highest revision rate (12.6%). The majority of fatalities was admitted as an emergency (81/91 patients, 89%). Ten elective patients had lethal complications, six of them related to surgery (0.2%). CONCLUSION: This study presents the one-year results of a prospectively compiled AE database. Neurosurgical AEs arose in one in five patients. Although the need for revision surgery was low, the rate of AEs highlights the importance of a systematic AE database to deliver continued high-quality in a high-volume center. CI - (c) 2022. The Author(s). FAU - Dao Trong, Philip AU - Dao Trong P AD - Department of Neurosurgery, University Hospital Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany. FAU - Olivares, Arturo AU - Olivares A AD - Department of Neurosurgery, University Hospital Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany. FAU - El Damaty, Ahmed AU - El Damaty A AD - Department of Neurosurgery, University Hospital Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany. FAU - Unterberg, Andreas AU - Unterberg A AUID- ORCID: 0000-0003-3742-3288 AD - Department of Neurosurgery, University Hospital Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany. Andreas.Unterberg@med.uni-heidelberg.de. LA - eng PT - Journal Article DEP - 20230110 PL - Austria TA - Acta Neurochir (Wien) JT - Acta neurochirurgica JID - 0151000 SB - IM MH - Humans MH - *Neurosurgery MH - Neurosurgical Procedures/adverse effects MH - Spine/surgery MH - Hospitalization MH - Postoperative Complications/etiology PMC - PMC10006024 OTO - NOTNLM OT - Adverse events OT - Morbidity and mortality OT - Neurosurgery OT - Post-operative complications OT - Quality management COIS- There authors declare no competing interests. EDAT- 2023/01/10 06:00 MHDA- 2023/03/15 06:00 PMCR- 2023/01/10 CRDT- 2023/01/09 23:22 PHST- 2022/09/06 00:00 [received] PHST- 2022/12/13 00:00 [accepted] PHST- 2023/01/10 06:00 [pubmed] PHST- 2023/03/15 06:00 [medline] PHST- 2023/01/09 23:22 [entrez] PHST- 2023/01/10 00:00 [pmc-release] AID - 10.1007/s00701-022-05462-w [pii] AID - 5462 [pii] AID - 10.1007/s00701-022-05462-w [doi] PST - ppublish SO - Acta Neurochir (Wien). 2023 Mar;165(3):585-593. doi: 10.1007/s00701-022-05462-w. Epub 2023 Jan 10.