Evidence map›Paper›PMID 32975455›Full record

ArticleGlobal spine journal2022

The Incidence, Risk Factors, and Complications Associated With Surgical Delay in Multilevel Fusion for Adult Spinal Deformity.

Sean M Wade, Donald R Fredericks, Michael J Elsenbeck, Patrick B Morrissey, Arjun S Sebastian, I David Kaye, Joseph S Butler, Scott C Wagner

Open access · goldAbstract read
In one paragraph

Article in Global spine journal, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
1.2field-weighted citation impact, top 20% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 11 citations in OpenAlex.

  1. Is delayed time to surgery associated with increased postoperative complications in patients with pathologic humerus fractures?European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2024
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 6 institutions in 2 countries.

Sean M WadeUniformed Services University-8395Walter Reed National Military Medical Center, Bethesda, MD, USA.ORCID https://orcid.org/0000-0002-2430-1399
Donald R FredericksUniformed Services University-8395Walter Reed National Military Medical Center, Bethesda, MD, USA.ORCID https://orcid.org/0000-0003-4614-5611
Michael J ElsenbeckUniformed Services University-8395Walter Reed National Military Medical Center, Bethesda, MD, USA.
Patrick B Morrissey19938Naval Medical Center San Diego, San Diego, CA, USA.
Arjun S SebastianMayo Clinic, Rochester, MN, USA.
I David KayeRothman Institute at Thomas Jefferson University, Philadelphia, PA, USA.
Joseph S ButlerMater Misericordiae University Hospital, Mater Private Hospital, Dublin, Ireland.
Scott C WagnerUniformed Services University-8395Walter Reed National Military Medical Center, Bethesda, MD, USA.ORCID https://orcid.org/0000-0001-9454-4022
Walter Reed National Military Medical Center · USMater Misericordiae University Hospital · IEMayo Clinic in Arizona · USNaval Medical Center San Diego · USThomas Jefferson University · USUniformed Services University of the Health Sciences · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

STUDY

designRetrospective database review.

objectivesThe incidence and risk factors for surgical delay of multilevel spine fusion for adult spinal deformity (ASD), and the complications corresponding therewith, remain unknown. The objectives of this study are to assess the incidence and risk factors for unexpected delay of elective multilevel spinal fusions on the date of surgery as well as the postoperative complications associated with these delays.

methodsWe conducted a retrospective review of the ACS-NSQIP database on patients undergoing elective spinal instrumentation of greater than 7 levels for ASD between the years 2005 and 2015. Preoperative risk factors for delay and postoperative complications were compared between the cohorts of patients with and without surgical delays.

resultsMultivariate analysis of 1570 (15.6%) patients identified advanced age, male sex, American Society of Anesthesiologists (ASA) Class 4, and history of smoking as independent risk factors for delay. Patients experiencing surgical delay demonstrated longer operative times, increased intraoperative bleeding, longer hospitalizations, and significantly higher rates of postoperative complications. Patients experiencing delay demonstrated an almost 7-fold increase in mortality rate (3.4% vs 0.5%,

conclusionsDelays in elective surgical care for spinal deformity are negatively related to patient outcomes. Advanced age, male sex, increased ASA class, and a history of smoking cigarettes place patients at risk for surgical delay of multilevel spinal fusion. Patients experiencing surgical delay are at higher risk for postoperative complications, including a 7-fold increase in mortality. These findings suggest that ASD surgery should be postponed in patients experiencing a delay, until modifiable risk factors can be medically optimized, and perhaps postponed indefinitely in those with nonmodifiable risk factors.

Indexed as

ACS-NSQIPadult spinal deformitycomplicationselective surgerymultilevel fusionsurgical delay

Identifiers

PMID32975455
PMCPMC9121150
OpenAlexW3088386957

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.