Golinvaux Nicholas S, Basques Bryce A, Bohl Daniel D, Yacob Alem, Grauer Jonathan N
From the Department of Orthopaedics and Rehabilitation, Yale School of Medicine, New Haven, CT.
Spine (Phila Pa 1976). 2015 Mar 1;40(5):342-8. doi: 10.1097/BRS.0000000000000747.
Retrospective cohort.
To compare demographics and perioperative outcomes between the Spine Patient Outcomes Research Trial (SPORT) lumbar degenerative spondylolisthesis arm and a similar population from the National Surgical Quality Improvement Program (NSQIP) database.
SPORT is a well-known surgical trial that investigated the benefits of surgical versus nonsurgical treatment in patients with various lumbar pathologies. However, the external validity of SPORT demographics and outcomes has not been fully established.
Surgical degenerative spondylolisthesis cases were identified from NSQIP between 2010 and 2012. This population was then compared with the SPORT degenerative spondylolisthesis study. These comparisons were based on published data from SPORT and included analyses of demographics, perioperative factors, and complications.
The 368 surgical patients with degenerative spondylolisthesis in SPORT were compared with 955 patients identified in NSQIP. Demographic comparisons were as follows: average age and race (no difference; P > 0.05 for each), sex (9.1% more female patients in SPORT; P = 0.002), smoking status (6.6% more smokers in NSQIP; P = 0.002), and average body mass index (1.1 kg/m greater in NSQIP; P = 0.005). Larger differences were noted in what surgical procedure was performed (P < 0.001), with the most notable difference being that the NSQIP population was much more likely to include interbody fusion than the SPORT population (52.4% vs. 12.5%). Most perioperative factors and complication rates were similar, including average operative time, wound infection, wound dehiscence, postoperative transfusion, and postoperative mortality (no differences; P > 0.05 for each). Average length of stay was shorter in NSQIP compared with SPORT (3.7 vs. 5.8 d; P = 0.042).
Though important differences in the distribution of surgical procedures were identified, this study supports the greater generalizability of the surgical SPORT degenerative spondylolisthesis study based on similar demographics and perioperative outcomes when compared with patients from the NSQIP database.
回顾性队列研究。
比较脊柱患者预后研究试验（SPORT）腰椎退行性椎体滑脱组与国家外科质量改进计划（NSQIP）数据库中相似人群的人口统计学特征及围手术期结局。
SPORT是一项著名的外科试验，研究了各种腰椎疾病患者手术治疗与非手术治疗的益处。然而，SPORT的人口统计学特征和结局的外部有效性尚未完全确立。
从NSQIP中识别出2010年至2012年期间接受手术治疗的退行性椎体滑脱病例。然后将该人群与SPORT退行性椎体滑脱研究进行比较。这些比较基于SPORT公布的数据，包括人口统计学分析、围手术期因素和并发症。
将SPORT中368例接受手术治疗的退行性椎体滑脱患者与NSQIP中识别出的955例患者进行比较。人口统计学比较如下：平均年龄和种族（无差异；每项P>0.05）、性别（SPORT中女性患者多9.1%；P=0.002）、吸烟状况（NSQIP中吸烟者多6.6%；P=0.002）以及平均体重指数（NSQIP中高1.1kg/m²；P=0.005）。在实施的手术程序方面存在较大差异（P<0.001），最显著的差异是NSQIP人群比SPORT人群更有可能进行椎间融合术（52.4%对12.5%）。大多数围手术期因素和并发症发生率相似，包括平均手术时间、伤口感染、伤口裂开、术后输血和术后死亡率（无差异；每项P>0.05）。与SPORT相比，NSQIP的平均住院时间更短（3.7天对5.8天；P=0.042）。
尽管在手术程序分布方面发现了重要差异，但与NSQIP数据库中的患者相比，本研究基于相似的人口统计学特征和围手术期结局，支持SPORT退行性椎体滑脱手术研究具有更高的普遍性。
3级。
