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成人脊柱畸形融合手术后早期术后并发症后的非计划再入院:一项多中心研究。

Unplanned Readmission Following Early Postoperative Complications After Fusion Surgery in Adult Spine Deformity: A Multicentric Study.

作者信息

Camino-Willhuber Gaston, Guiroy Alfredo, Servidio Mariano, Astur Nelson, Nin-Vilaró Fernando, Alvarado-Gomez Fernando, Daher Murilo, Saciloto Bruno, Ono Allan, Letaif Olavo, Zarate-Kalfopulos Baron, Yurac Ratko, Vialle Emiliano, Valacco Marcelo

机构信息

Institute of Orthopedics "Carlos E. Ottolenghi," Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.

AOSpine Latin America Study Group, Curitiba, Brazil.

出版信息

Global Spine J. 2023 Jan;13(1):74-80. doi: 10.1177/2192568221991101. Epub 2021 Jan 28.

Abstract

STUDY DESIGN

Multicentric retrospective study, Level of evidence III.

OBJECTIVE

The objective of this multicentric study was to analyze the prevalence and risk factors of early postoperative complications in adult spinal deformity patients treated with fusion. Additionally, we studied the impact of complications on unplanned readmission and hospital length of stay.

METHODS

Eight spine centers from 6 countries in Latin America were involved in this study. Patients with adult spinal deformity treated with fusion surgery from 2017 to 2019 were included. Baseline and surgical characteristics such as age, sex, comorbidities, smoking, number of levels fused, number of surgical approaches were analyzed. Postoperative complications at 30 days were recorded according to Clavien-Dindo and Glassman classifications.

RESULTS

172 patients (120 females/52 males, mean age 59.4 ± 17.6) were included in our study. 78 patients suffered complications (45%) at 30 days, 43% of these complications were considered major. Unplanned readmission was observed in 35 patients (20,3%). Risk factors for complications were: Smoking, previous comorbidities, number of levels fused, two or more surgical approaches and excessive bleeding. Hospital length of stay in patients without and with complications was of 7.8 ± 13.7 and 17 ± 31.1 days, respectively ( 0.0001).

CONCLUSION

The prevalence of early postoperative complications in adult spinal deformity patients treated with fusion was of 45% in our study with 20% of unplanned readmissions at 30 days. Presence of complications significantly increased hospital length of stay.

摘要

研究设计

多中心回顾性研究,证据等级为III级。

目的

本多中心研究旨在分析接受融合手术的成人脊柱畸形患者术后早期并发症的发生率及危险因素。此外,我们还研究了并发症对非计划再入院率和住院时间的影响。

方法

来自拉丁美洲6个国家的8个脊柱中心参与了本研究。纳入2017年至2019年接受融合手术治疗的成人脊柱畸形患者。分析了年龄、性别、合并症、吸烟情况、融合节段数、手术入路数等基线和手术特征。根据Clavien-Dindo和Glassman分类记录术后30天的并发症情况。

结果

本研究共纳入172例患者(120例女性/52例男性,平均年龄59.4±17.6岁)。78例患者(45%)在术后30天出现并发症,其中43%的并发症被认为是严重的。35例患者(20.3%)出现非计划再入院。并发症的危险因素包括:吸烟、既往合并症、融合节段数、两种或更多手术入路以及出血过多。无并发症患者和有并发症患者的住院时间分别为7.8±13.7天和17±31.1天(P<0.0001)。

结论

在我们的研究中,接受融合手术的成人脊柱畸形患者术后早期并发症的发生率为45%,30天非计划再入院率为20%。并发症的出现显著延长了住院时间。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4b85/9837501/51702478fc96/10.1177_2192568221991101-fig1.jpg

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