Towner James E, Li Yan Icy, Pieters Thomas A, Li Yan Michael
Department of Neurosurgery, University of Rochester Medical Center, Rochester, New York.
Int J Spine Surg. 2020 Jun 30;14(3):412-417. doi: 10.14444/7054. eCollection 2020 Jun.
There exists no large, multi-institutional analysis of patients undergoing cervical corpectomy for common degenerative spinal disease, including patient demographics and comorbidities as well as postoperative complications.
Using Current Procedural Terminology and International Classification of Diseases codes, 1972 patients who underwent a cervical corpectomy for degenerative spinal disease were identified from the American College of Surgeons National Surgical Quality Improvement Program data sets from 2012 to 2015. A descriptive analysis of the patients who underwent the procedure as well as 30-day outcomes and adverse events were collected. Multivariate logistic regression models were used to determine the effect of any preoperative factors identified from a univariate logistic regression analysis (variables with < .10) of complications.
The total complication rate, defined as major or minor adverse event, mortality, unplanned readmission, unplanned reoperation, or admission >30 days, was 13.28%. The percentage of patients who had ≥1 major or minor adverse events was 5.02%. Several factors commonly associated with an increased risk of perioperative complications, including smoking and diabetes, were found not to be independently associated with complications in this cohort.
This study is the largest analysis of cervical corpectomies. The results of the multivariate analysis provide guidance on risk factors associated with perioperative complications. These data could help develop risk-appropriate strategies for minimizing the effects of certain preoperative factors on perioperative complications.
对于因常见退行性脊柱疾病接受颈椎椎体次全切除术的患者,目前尚无大规模的多机构分析,包括患者人口统计学特征、合并症以及术后并发症。
利用当前手术操作术语和国际疾病分类编码,从美国外科医师学会国家外科质量改进计划2012年至2015年的数据集中识别出1972例因退行性脊柱疾病接受颈椎椎体次全切除术的患者。收集了接受该手术患者的描述性分析以及30天的结局和不良事件。使用多变量逻辑回归模型来确定从并发症的单变量逻辑回归分析(P<0.10的变量)中识别出的任何术前因素的影响。
总并发症发生率定义为严重或轻微不良事件、死亡率、计划外再入院、计划外再次手术或住院时间>30天,为13.28%。发生≥1次严重或轻微不良事件的患者百分比为5.02%。在该队列中,发现一些通常与围手术期并发症风险增加相关的因素,包括吸烟和糖尿病,与并发症并无独立关联。
本研究是对颈椎椎体次全切除术规模最大的分析。多变量分析结果为围手术期并发症相关的风险因素提供了指导。这些数据有助于制定风险适宜的策略,以尽量减少某些术前因素对围手术期并发症的影响。