Department of Orthopaedics and Trauma Surgery, Vienna General Hospital, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.
Adult Reconstruction and Joint Replacement Division, Hospital for Special Surgery, 535 East 70th Street, New York, NY, 10021, USA.
Eur Spine J. 2018 Oct;27(10):2449-2456. doi: 10.1007/s00586-018-5707-9. Epub 2018 Jul 28.
The preoperative prediction of medical complications is essential to optimize perioperative management. SpineSage™ is a free of charge online calculator to predict medical complications in spine surgery. The current study utilizes it in patients undergoing spine surgery to assess whether the predicted risks would correlate with the actual complication rate in clinical practice.
A total of 273 consecutive patients who underwent spinal surgery were assessed. The risk of medical complications was predicted for each patient, and all medical complications were recorded within 30 days of surgery. Based on their predicted risk of complication, patients were divided into three risk groups (< 15, 15-30, > 30%).
The predicted overall risk of medical complications was 14.7% and was comparable to the observed complication rate of 16.1%. The predicted risk for major medical complications (3.8%) was also similar to the observed complication rate (3.3%). Detailed analysis of the segmented risk groups suggests a close correlation between predicted and actual complication rates. Receiver operating characteristic analysis revealed an area under the curve of 0.71 (p < 0.001) for the prediction of overall medical complications and 0.85 (p < 0.001) for major complications.
The online risk calculator predicted both overall and major medical complications. The tool can assist in preoperative planning and counseling of patients. These slides can be retrieved under Electronic Supplementary Material.
预测医疗并发症对于优化围手术期管理至关重要。SpineSage™是一款免费的在线计算器，可用于预测脊柱手术中的医疗并发症。本研究在接受脊柱手术的患者中使用该计算器，以评估预测风险是否与临床实践中的实际并发症发生率相关。
共评估了 273 例连续接受脊柱手术的患者。对每位患者的医疗并发症风险进行预测，并在术后 30 天内记录所有医疗并发症。根据预测的并发症风险，患者被分为三组风险等级（<15、15-30、>30）。
预测的总体医疗并发症风险为 14.7%，与观察到的并发症发生率 16.1%相当。预测的主要医疗并发症风险（3.8%）也与观察到的并发症发生率（3.3%）相似。对细分风险组的详细分析表明，预测和实际并发症发生率之间存在密切相关性。受试者工作特征分析显示，预测总体医疗并发症的曲线下面积为 0.71（p<0.001），预测主要并发症的曲线下面积为 0.85（p<0.001）。
在线风险计算器可预测总体和主要医疗并发症。该工具可用于术前规划和患者咨询。这些幻灯片可在电子补充材料中找到。
