Solumsmoen Stian, Bari Tanvir Johanning, Woldu Sarah, Zielinski Oliver Bremerskov, Gehrchen Martin, Dahl Benny, Bech-Azeddine Rachid
Copenhagen Spine Research Unit (CSRU), Section of Spine Surgery, Center of Rheumatology and Spine Diseases, Rigshospitalet, Glostrup, Denmark.
Department of Epidemiological Research, Statens Serum Institut, Copenhagen, Denmark.
Neurospine. 2021 Sep;18(3):524-532. doi: 10.14245/ns.2040628.314. Epub 2021 Mar 22.
The reported incidence of complications and/or adverse events (AEs) following spine surgery varies greatly. A validated, systematic, reproducible reporting system to quantify AEs was used in 2 prospective cohorts, from 2 spine surgery centers, conducting either complex or purely degenerative spine surgery; in a comparative fashion. The aim was to highlight the differences between 2 distinctly different prospective cohorts with patients from the same background population.
AEs were registered according to the predefined AE variables in the SAVES (Spine AdVerse Events Severity) system which was used to record all intra- and perioperative AEs. Additional outcomes, including mortality, length of stay, wound infection requiring revision, readmission, and unplanned revision surgery during the index admission, were also registered.
A total of 593 complex and 1,687 degenerative procedures were consecutively included with 100% data completion. There was a significant difference in morbidity when comparing the total number of AEs between the 2 groups (p < 0.001): with a mean number of 1.42 AEs per patient (n = 845) in the complex cohort, and 0.97 AEs per patient (n = 1,630) in the degenerative cohort.
In this prospective study comparing 2 cohorts, we report the rates of AEs related to spine surgery using a validated reproducible grading system for registration. The rates of morbidity and mortality were significantly higher following complex spine surgery compared to surgery for degenerative spine disease.
脊柱手术后并发症和/或不良事件（AE）的报告发生率差异很大。在两个脊柱手术中心进行的两个前瞻性队列研究中，采用了经过验证的、系统的、可重复的报告系统来量化AE，这两个队列分别进行复杂或单纯退行性脊柱手术；采用对比的方式。目的是突出来自相同背景人群的两个截然不同的前瞻性队列之间的差异。
根据SAVES（脊柱不良事件严重程度）系统中预定义的AE变量记录AE，该系统用于记录所有术中和围手术期AE。还记录了其他结果，包括死亡率、住院时间、需要翻修的伤口感染、再入院以及索引住院期间的计划外翻修手术。
共连续纳入593例复杂手术和1687例退行性手术，数据完成率为100%。两组之间比较AE总数时，发病率有显著差异（p < 0.001）：复杂队列中每位患者平均AE数为1.42（n = 845），退行性队列中每位患者平均AE数为0.97（n = 1630）。
在这项比较两个队列的前瞻性研究中，我们使用经过验证的可重复分级系统报告了与脊柱手术相关的AE发生率。与退行性脊柱疾病手术相比，复杂脊柱手术后的发病率和死亡率显著更高。
