Turcotte Justin J, Patton Chad M
Department of Surgery (Mr. Turcotte), and the Department of Orthopedics (Dr. Patton), Anne Arundel Medical Center, Annapolis, MD.
J Am Acad Orthop Surg Glob Res Rev. 2018 Dec 4;2(12):e085. doi: 10.5435/JAAOSGlobal-D-18-00085. eCollection 2018 Dec.
The aim of this study was to determine the predictors of 30-day postoperative complications for surgical treatment of lumbar spinal stenosis with degenerative spondylolisthesis (LSSDS) in patients undergoing decompression and fusion or decompression alone.
A retrospective review of 253 unique patients undergoing surgical intervention for LSSDS in the American College of Surgeons National Surgical Quality Improvement Program database was conducted.
The overall 30-day postoperative complication rate for the population was 16.6% (95% confidence interval [CI], 12.0% to 21.0%). Transfusions (8.9%), readmissions (5.9%), and unplanned returns to the OR (3.6%) were the most frequently observed complications across the population. ASA score and surgical time were found to be significant predictors of 30-day complications (ASA score: OR = 1.971; 95% CI, 1.077 to 3.609; = 0.028; surgical time: OR = 1.006; 95% CI, 1.003 to 1.010; < 0.001). Holding all other variables constant, multilevel cases, the inclusion of a fusion procedure, and body mass index were not found to be significant predictors of 30-day complications ( = 0.917, = 0.464, and = 0.572, respectively).
ASA score and OR time are leading indicators of complications, specifically for the LSSDS patient population. These are two easily attainable data points that are available for all surgical cases and could be used a clinical red flag for potential complications.
本研究的目的是确定在接受减压融合术或单纯减压术的腰椎管狭窄症伴退行性椎体滑脱（LSSDS）患者中，术后30天并发症的预测因素。
对美国外科医师学会国家外科质量改进计划数据库中253例接受LSSDS手术干预的患者进行回顾性研究。
该人群术后30天的总体并发症发生率为16.6%（95%置信区间[CI]，12.0%至21.0%）。输血（8.9%）、再入院（5.9%）和非计划返回手术室（3.6%）是该人群中最常观察到的并发症。美国麻醉医师协会（ASA）评分和手术时间被发现是30天并发症的重要预测因素（ASA评分：比值比[OR]=1.971；95%CI，1.077至3.609；P=0.028；手术时间：OR=1.006；95%CI，1.003至1.010；P<0.001）。在所有其他变量保持不变的情况下，多级病例、融合手术的纳入和体重指数未被发现是30天并发症的重要预测因素（P分别为0.917、0.464和0.572）。
ASA评分和手术时间是并发症的主要指标，特别是对于LSSDS患者群体。这是两个易于获得的所有手术病例都有的数据点，可作为潜在并发症的临床警示信号。
