Evidence map›Paper›PMID 38492171›Full record

ArticleSpine deformity2024

The effect of surgical time on perioperative complications in adolescent idiopathic scoliosis cases. A propensity score analysis.

McKenna C Noe, Daniel Hagaman, Brittany Sipp, Fahad Qureshi, Jonathan R Warren, Ellie Kaji, Ashley Sherman, Richard M Schwend

Abstract read
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In one paragraph

Article in Spine deformity, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
1.1field-weighted citation impact, top 24% 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

3 citing papers in PubMed, 1 synthesis or guideline pooled it, 2 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. 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 4 institutions in 1 country.

McKenna C NoeDepartment of Orthopaedic Surgery, Children's Mercy Kansas City, 2401 Gillham Road, Kansas City, MO, 64108, USA.ORCID 0000-0002-9538-3467
Daniel HagamanDepartment of Orthopaedic Surgery, University of Missouri Kansas City, Kansas City, MO, USA.ORCID 0000-0002-3446-0393
Brittany SippDepartment of Surgery, University of Missouri Kansas City, Kansas City, MO, USA.
Fahad QureshiDepartment of Interventional Radiology, Loma Linda University, Loma Linda, CA, USA.ORCID 0000-0003-1117-1350
Jonathan R WarrenDepartment of Orthopaedic Surgery, Children's Mercy Kansas City, 2401 Gillham Road, Kansas City, MO, 64108, USA.ORCID 0000-0002-7205-7191
Ellie KajiUniversity of Missouri Kansas City School of Medicine, Kansas City, MO, USA.ORCID 0009-0009-8745-7612
Ashley ShermanDepartment of Orthopaedic Surgery, Children's Mercy Kansas City, 2401 Gillham Road, Kansas City, MO, 64108, USA.ORCID 0000-0003-2852-5223
Richard M SchwendDepartment of Orthopaedic Surgery, Children's Mercy Kansas City, 2401 Gillham Road, Kansas City, MO, 64108, USA. rmschwend@cmh.edu.ORCID 0000-0002-0620-4421
Mercy Hospital · USUniversity of Missouri–Kansas City · USChildren's Mercy Hospital · USLoma Linda University · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPosterior spinal instrumentation and fusion (PSIF) for adolescent idiopathic scoliosis (AIS) can be lengthy and complication-ridden. The aim of this study was to evaluate the effect of surgical time on perioperative complications in this procedure when controlling for confounding variables with propensity score analysis.

methodsThis was an IRB-approved review of electronic health records from 2010 to 2019 at a single tertiary care children's hospital. Patients undergoing PSIF were grouped into "short" (< 6 h) or "long" (≥ 6 h) surgical time groups. Outcome measures were estimated blood loss (EBL), cell saver transfusions, packed red blood cell (pRBC) transfusions, length of stay (LOS), intraoperative monitoring (IOM) alerts, hematocrit, ICU transfer, neurologic loss, surgical site infection, and 90-day readmissions. We controlled for age, sex, BMI, curve severity, number of segments fused, and surgeon factors.

resultsAfter propensity score matching there were 113 patients in each group. The short surgical time group had lower EBL (median 715, IQR 550-900 vs median 875, IQR 650-1100 cc; p < 0.001), received less cell saver blood (median 120, IQR 60-168 vs median 160, IQR 97-225 cc; p = 0.001), received less intraoperative pRBCs (median 0, IQR 0-0 vs median 0, IQR 0-320, p = 0.002), had shorter average LOS (4.8 ± 1.7 vs 5.4 ± 2.5 days; p = 0.039), and fewer IOM alerts (4.3% vs 18%, p = 0.003).

conclusionsPatients with shorter surgical times had less blood loss, received less transfused blood, had a shorter LOS, and fewer IOM alerts compared to patients with longer surgical times. Surgical times < 6 h may have safety and efficacy advantages over longer times. LEVEL OF EVIDENCE: III.

Indexed as

Operative TimePostoperative ComplicationsPropensity ScoreScoliosisSpinal FusionAdolescentBlood Loss, SurgicalChildFemaleHumansLength of StayMaleRetrospective StudiesAISBlood lossPerioperative complicationsScoliosisSurgical time

Identifiers

PMID38492171
OpenAlexW4392881456

What OpenQuestion holds

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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.