Department of Orthopedic Surgery, Institute of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba City, Ibaraki, 305-8575, Japan.
Department of Orthopedic Surgery, Ibaraki Western Medical Center, Chikusei City, Ibaraki, Japan.
Sci Rep. 2024 Sep 10;14(1):21112. doi: 10.1038/s41598-024-72202-8.
Assessing intraoperative hemodynamics with Surgical Apgar Score (SAS) and preoperative nutritional status with the Controlling Nutritional Status (CONUT) score are said to be useful to predict postoperative complications in many surgical services, but little is reported in the field of spinal surgery. The purpose of this study was to assess the utility of SAS and the CONUT score for predicting the risk of major postoperative complications after spinal surgery. We included 659 people who undergone spinal surgery in our institute in eight consecutive years. The occurrence of postoperative major complications was investigated. Background clinical information, surgical information including the SAS and the CONUT score, and the length of postoperative hospital stay were collected. The risk factors of postoperative complications were assessed statistically. Complications occurred in 117 cases (17.8%). The multivariate analysis showed that history of diabetes mellitus (odds ratio [OR] 1.81: P = 0.035), coronary disease (OR 3.33; P = 0.009), American Society of Anesthesiologists Physical Status (OR 1.71; P = 0.025), use of instruments (OR 2.07; P = 0.026), operation time (OR 1.30; P < 0.001), SAS (OR 0.59; P < 0.001), and CONUT (OR 1.34; P < 0.001) were independent risk factors of major complications after spinal surgery. Assessing the intraoperative hemodynamics with SAS and preoperative nutritional status with the CONUT score was useful in predicting major postoperative complications after spinal surgery. People who are detected as high risked people should be managed carefully after spinal surgery.
评估术中血流动力学的外科 Apgar 评分(SAS)和术前营养状况的控制营养状况(CONUT)评分被认为可用于预测许多外科手术的术后并发症,但在脊柱外科领域报道甚少。本研究旨在评估 SAS 和 CONUT 评分在预测脊柱手术后主要术后并发症风险方面的作用。我们连续 8 年纳入我院 659 例接受脊柱手术的患者。调查术后主要并发症的发生情况。收集背景临床资料、手术信息(包括 SAS 和 CONUT 评分)和术后住院时间。对术后并发症的危险因素进行统计学评估。117 例(17.8%)发生并发症。多因素分析显示,糖尿病史(比值比 [OR] 1.81:P = 0.035)、冠心病(OR 3.33;P = 0.009)、美国麻醉医师协会身体状况(OR 1.71;P = 0.025)、使用器械(OR 2.07;P = 0.026)、手术时间(OR 1.30;P < 0.001)、SAS(OR 0.59;P < 0.001)和 CONUT(OR 1.34;P < 0.001)是脊柱手术后主要并发症的独立危险因素。评估术中血流动力学的 SAS 和术前营养状况的 CONUT 评分有助于预测脊柱手术后的主要术后并发症。被检测为高危人群的人在脊柱手术后应谨慎管理。