Evidence map›Paper›PMID 29732423›Full record

ArticleJournal of spine surgery (Hong Kong)2018

Predicting critical care unit-level complications after long-segment fusion procedures for adult spinal deformity.

Rafael De la Garza-Ramos, Jonathan Nakhla, Yaroslav Gelfand, Murray Echt, Aleka N Scoco, Merritt D Kinon, Reza Yassari

Abstract read
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Article in Journal of spine surgery (Hong Kong), 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

7 authors.

Rafael De la Garza-RamosSpine Research Group, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York, USA.
Jonathan NakhlaSpine Research Group, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York, USA.
Yaroslav GelfandSpine Research Group, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York, USA.
Murray EchtSpine Research Group, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York, USA.
Aleka N ScocoSpine Research Group, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York, USA.
Merritt D KinonSpine Research Group, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York, USA.
Reza YassariSpine Research Group, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTo identify predictive factors for critical care unit-level complications (CCU complication) after long-segment fusion procedures for adult spinal deformity (ASD).

methodsThe American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database [2010-2014] was reviewed. Only adult patients who underwent fusion of 7 or more spinal levels for ASD were included. CCU complications included intraoperative arrest/infarction, ventilation >48 hours, pulmonary embolism, renal failure requiring dialysis, cardiac arrest, myocardial infarction, unplanned intubation, septic shock, stroke, coma, or new neurological deficit. A stepwise multivariate regression was used to identify independent predictors of CCU complications.

resultsAmong 826 patients, the rate of CCU complications was 6.4%. On multivariate regression analysis, dependent functional status (P=0.004), combined approach (P=0.023), age (P=0.044), diabetes (P=0.048), and surgery for over 8 hours (P=0.080) were significantly associated with complication development. A simple scoring system was developed to predict complications with 0 points for patients aged <50, 1 point for patients between 50-70, 2 points for patients 70 or over, 1 point for diabetes, 2 points dependent functional status, 1 point for combined approach, and 1 point for surgery over 8 hours. The rate of CCU complications was 0.7%, 3.2%, 9.0%, and 12.6% for patients with 0, 1, 2, and 3+ points, respectively (P<0.001).

conclusionsThe findings in this study suggest that older patients, patients with diabetes, patients who depend on others for activities of daily living, and patients who undergo combined approaches or surgery for over 8 hours may be at a significantly increased risk of developing a CCU-level complication after ASD surgery.

Indexed as

Adult spinal deformity (ASD)Clavien-Dindo complicationscritical caremajor complicationsNational Surgical Quality Improvement Program (NSQIP)

Identifiers

PMID29732423
PMCPMC5911765

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