PMID- 37119107 OWN - NLM STAT- MEDLINE DCOM- 20230803 LR - 20230803 IS - 1547-5646 (Electronic) IS - 1547-5646 (Linking) VI - 39 IP - 2 DP - 2023 Aug 1 TI - Generic versus disease-specific adverse event reporting: a comparison of the NSQIP and SAVES databases for the identification of acute care adverse events in adult spine surgery. PG - 263-270 LID - 10.3171/2023.3.SPINE221437 [doi] AB - OBJECTIVE: The accurate identification and reporting of adverse events (AEs) is crucial for quality improvement. A myriad of AE systems are utilized. There is a lack of understanding of the differences between prospective versus retrospective, disease-specific versus generic, and point-of-care versus chart-abstracted systems. The objective of this study was to compare the benefits and limitations between the prospective, disease-specific, point-of-care Spine Adverse Events Severity System (SAVES) and the retrospective, generic, and chart-abstracted National Surgical Quality Improvement Program (NSQIP) for the identification and reporting of AEs in adult patients undergoing spinal surgery. METHODS: The authors conducted an observational ambidirectional cohort study of adult patients undergoing spine surgery other than for trauma between 2011 and 2019 in a quaternary spine center. Patients were identified using Current Procedural Terminology codes in the NSQIP database and matched using unique medical record numbers to their corresponding record in SAVES. The incidence of AEs and per-patient AEs as recorded in NSQIP and SAVES was the primary outcome of interest. Comparable AEs were identified by matching NSQIP AEs to equivalent ones in SAVES. Chi-square tests were used to test for significant differences in the incidence of overall and comparable AEs between the databases. RESULTS: There were 2198 patients identified in NSQIP, of whom 2033 also had complete records in SAVES. SAVES identified 5342 individual AEs in 1484 patients (73%) compared with 1291 individual AEs in 807 patients (39.7%) with the NSQIP database (p < 0.001). SAVES identified 250 intraoperative and 422 postoperative spine-specific AEs that NSQIP did not record. NSQIP captured a greater number of AEs beyond 30 days, including prolonged length of stay > 30 days, unplanned readmission, unplanned reoperation, and death later than 30 days after surgery compared with SAVES. CONCLUSIONS: SAVES captures a greater incidence of peri- and intraoperative spine-specific AEs than NSQIP, while NSQIP identifies a greater number of AEs beyond 30 days. While a prospective, disease-specific, point-of-care AE system such as SAVES is specific for guiding quality improvement in spine surgery, it incurs greater time and financial costs. Conversely, a retrospective, generic, and chart-abstracted system such as NSQIP provides equivocal cross-institutional comparability with reduced time and financial costs. Specific contextual and aim-specific needs should guide the choice and implementation of an AE system. FAU - Moskven, Eryck AU - Moskven E AD - 1Department of Orthopedic Surgery, Combined Neurosurgical and Orthopedic Spine Program, University of British Columbia; and. FAU - Daly, Christopher D AU - Daly CD AD - 1Department of Orthopedic Surgery, Combined Neurosurgical and Orthopedic Spine Program, University of British Columbia; and. FAU - Nevin, Jennifer AU - Nevin J AD - 2Department of Orthopedic Surgery, University of British Columbia, Vancouver, British Columbia, Canada. FAU - Bourassa-Moreau, Etienne AU - Bourassa-Moreau E AD - 1Department of Orthopedic Surgery, Combined Neurosurgical and Orthopedic Spine Program, University of British Columbia; and. FAU - Ailon, Tamir AU - Ailon T AD - 1Department of Orthopedic Surgery, Combined Neurosurgical and Orthopedic Spine Program, University of British Columbia; and. FAU - Charest-Morin, Raphaele AU - Charest-Morin R AD - 1Department of Orthopedic Surgery, Combined Neurosurgical and Orthopedic Spine Program, University of British Columbia; and. FAU - Dea, Nicolas AU - Dea N AD - 1Department of Orthopedic Surgery, Combined Neurosurgical and Orthopedic Spine Program, University of British Columbia; and. FAU - Dvorak, Marcel F AU - Dvorak MF AD - 1Department of Orthopedic Surgery, Combined Neurosurgical and Orthopedic Spine Program, University of British Columbia; and. FAU - Fisher, Charles G AU - Fisher CG AD - 1Department of Orthopedic Surgery, Combined Neurosurgical and Orthopedic Spine Program, University of British Columbia; and. FAU - Kwon, Brian K AU - Kwon BK AD - 1Department of Orthopedic Surgery, Combined Neurosurgical and Orthopedic Spine Program, University of British Columbia; and. FAU - Paquette, Scott AU - Paquette S AD - 1Department of Orthopedic Surgery, Combined Neurosurgical and Orthopedic Spine Program, University of British Columbia; and. FAU - Street, John T AU - Street JT AD - 1Department of Orthopedic Surgery, Combined Neurosurgical and Orthopedic Spine Program, University of British Columbia; and. LA - eng PT - Journal Article DEP - 20230428 PL - United States TA - J Neurosurg Spine JT - Journal of neurosurgery. Spine JID - 101223545 SB - IM MH - Humans MH - Adult MH - Cohort Studies MH - Retrospective Studies MH - Prospective Studies MH - *Quality Improvement MH - *Postoperative Complications/epidemiology OTO - NOTNLM OT - National Surgical Quality Improvement Program OT - Spine Adverse Events Severity System OT - complications OT - safety EDAT- 2023/04/29 19:43 MHDA- 2023/08/03 06:43 CRDT- 2023/04/29 07:23 PHST- 2022/12/31 00:00 [received] PHST- 2023/03/14 00:00 [accepted] PHST- 2023/08/03 06:43 [medline] PHST- 2023/04/29 19:43 [pubmed] PHST- 2023/04/29 07:23 [entrez] AID - 10.3171/2023.3.SPINE221437 [doi] PST - epublish SO - J Neurosurg Spine. 2023 Apr 28;39(2):263-270. doi: 10.3171/2023.3.SPINE221437. Print 2023 Aug 1.