PMID- 37555998
OWN - NLM
STAT- MEDLINE
DCOM- 20230905
LR  - 20231012
IS  - 0942-0940 (Electronic)
IS  - 0001-6268 (Print)
IS  - 0001-6268 (Linking)
VI  - 165
IP  - 9
DP  - 2023 Sep
TI  - Adverse events in spine surgery: a prospective analysis at a large tertiary 
      center in Germany.
PG  - 2689-2697
LID - 10.1007/s00701-023-05752-x [doi]
AB  - STUDY DESIGN: Prospective study OBJECTIVES: The occurrence of adverse events 
      (AEs) during surgery is a major cause of increased economic costs, disability, or 
      even death. This study aimed to prospectively identify and quantify AEs in 
      patients undergoing spinal surgery at a neurosurgical tertiary care hospital. 
      METHODS: Patients who underwent spinal surgery and were discharged between 
      January 2019 and December 2022 were enrolled prospectively. Each patient 
      underwent a peer-reviewed AE evaluation at discharge. An AE was defined as any 
      event that occurred up to 30 days postoperatively and resulted in an undesirable 
      outcome. Patients were allocated to four groups according to spinal pathology 
      (degenerative, oncologic, traumatic, and infectious). RESULTS: During the study 
      period, 1778 patients with a mean age of 55.4 +/- 10.5 years underwent surgery. 
      Elective surgery was performed in 90.8% (1615/1778) of patients, while emergency 
      surgery was performed in 9.2% (163/1778). The overall rate of surgery-related AEs 
      was relatively low (8.7%). Degenerative pathologies were the most frequent 
      reasons for surgery (78.5%, 1396/1778). Wound infection was the most prevalent AE 
      in patients with degenerative diseases (1.4%), of which 1.1% required revision 
      surgery. Wound infection, dural leakage, and new neurological deficits had the 
      same prevalence (2.1%) in patients with spinal tumors. Among patients with spinal 
      trauma, two presented with postoperative epidural bleeding and underwent 
      emergency surgery. Postoperative wound infection was the most prevalent AE in 
      this group (9.5%), with 7.0% of affected patients requiring revision surgery. The 
      overall rate of non-surgery-related AEs was 4.3%, and the overall mortality rate 
      was low (0.4%). CONCLUSION: AEs in spinal surgery remained low, with a prevalence 
      of 8.7%. Documentation of AEs as part of clinical routine may be a key tool for 
      identifying the occurrence of surgery-related and non-surgery-related AEs.
CI  - (c) 2023. The Author(s).
FAU - Lenga, Pavlina
AU  - Lenga P
AD  - Department of Neurosurgery, Heidelberg University Hospital, Im Neuenheimer Feld 
      400, 69120, Heidelberg, Germany. pavlina.lenga@med.uni-heidelberg.de.
FAU - Trong, Philip Dao
AU  - Trong PD
AD  - Department of Neurosurgery, Heidelberg University Hospital, Im Neuenheimer Feld 
      400, 69120, Heidelberg, Germany.
FAU - Papakonstantinou, Vassilios
AU  - Papakonstantinou V
AD  - Department of Neurosurgery, Heidelberg University Hospital, Im Neuenheimer Feld 
      400, 69120, Heidelberg, Germany.
FAU - Kiening, Karl
AU  - Kiening K
AD  - Department of Neurosurgery, Heidelberg University Hospital, Im Neuenheimer Feld 
      400, 69120, Heidelberg, Germany.
FAU - Unterberg, Andreas W
AU  - Unterberg AW
AD  - Department of Neurosurgery, Heidelberg University Hospital, Im Neuenheimer Feld 
      400, 69120, Heidelberg, Germany.
FAU - Ishak, Basem
AU  - Ishak B
AD  - Department of Neurosurgery, Heidelberg University Hospital, Im Neuenheimer Feld 
      400, 69120, Heidelberg, Germany.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20230809
PL  - Austria
TA  - Acta Neurochir (Wien)
JT  - Acta neurochirurgica
JID - 0151000
SB  - IM
MH  - Humans
MH  - Adult
MH  - Middle Aged
MH  - Aged
MH  - Spine/surgery
MH  - *Spinal Injuries/surgery
MH  - *Spinal Neoplasms/surgery
MH  - Germany
MH  - Surgical Wound Infection
MH  - Postoperative Hemorrhage
MH  - Postoperative Complications/epidemiology
MH  - Retrospective Studies
PMC - PMC10477100
OTO - NOTNLM
OT  - Adverse events
OT  - Dural leakage
OT  - Spinal surgery
OT  - Tertiary care
OT  - Wound infection
COIS- The authors declare no competing interests.
EDAT- 2023/08/09 12:56
MHDA- 2023/09/05 06:41
PMCR- 2023/08/09
CRDT- 2023/08/09 11:16
PHST- 2023/06/13 00:00 [received]
PHST- 2023/07/31 00:00 [accepted]
PHST- 2023/09/05 06:41 [medline]
PHST- 2023/08/09 12:56 [pubmed]
PHST- 2023/08/09 11:16 [entrez]
PHST- 2023/08/09 00:00 [pmc-release]
AID - 10.1007/s00701-023-05752-x [pii]
AID - 5752 [pii]
AID - 10.1007/s00701-023-05752-x [doi]
PST - ppublish
SO  - Acta Neurochir (Wien). 2023 Sep;165(9):2689-2697. doi: 
      10.1007/s00701-023-05752-x. Epub 2023 Aug 9.