Department of Spine Surgery, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy.
ISNB Istituto delle Scienze Neurologiche di Bologna, Via Altura,3, Bologna, 40139, Italy.
J Orthop Surg Res. 2024 Sep 14;19(1):567. doi: 10.1186/s13018-024-05066-3.
In spinal surgery adverse events (AE) and surgical complications (SC) significantly affect patient's outcome and quality of life. The duration of surgery has been investigated in different surgical field as risk factor for complications. The aim of this study is to analyze the correlation between operative time and adverse events in spinal surgery.
We retrospectively analyzed data collected prospectively in a cohort of 336 patients surgically treated for spinal diseases of oncological and degenerative origin in a single center, between January 2017 to January 2018. Demographics and clinical data were collected. Adverse events were classified using Spinal Adverse Events Severity System version 2 (SAVES-V2) capture system. Focusing on degenerative patients, bivariate analysis and univariate logistic regression were used to determine the association between operative time and complications.
A total of 105/336 patients experienced an AE related to surgery, respectively 38% in the oncological group and 28% in the degenerative group. The average age at surgery was 60.3 years (SD 17.1) and the mean operative time was 164.8 ± 138 min. A total of 206 adverse events (30 intraoperative, 135 early postoperative and 41 late postoperative AEs) were recorded. Early post-operative complications accounted for the most recorded AEs (55.5% in the oncological group and 73.2% in the degenerative group). Univariate logistic regression analyses confirmed that operative time correlated with increased risk of intra-operative (p-value = 0.0008), early post-operative (p-value < 0.001) and late post-operative (p-value < 0.001) adverse events.
This study highlights the strong correlation between the occurrence of adverse events in spinal surgery and prolonged operative time and suggests that efforts should be made to minimize the duration of surgical procedures while prioritizing patient's safety, without compromising the technical achievement of the procedure.
在脊柱外科手术中，不良事件（AE）和手术并发症（SC）会显著影响患者的预后和生活质量。手术时间已在不同的外科领域被研究为并发症的危险因素。本研究旨在分析脊柱手术中手术时间与不良事件之间的相关性。
我们回顾性分析了 2017 年 1 月至 2018 年 1 月期间在一家单中心接受脊柱肿瘤和退行性疾病手术治疗的 336 例患者前瞻性收集的数据。收集了人口统计学和临床数据。使用脊柱不良事件严重程度系统第 2 版（SAVES-V2）采集系统对不良事件进行分类。针对退行性疾病患者，采用双变量分析和单变量逻辑回归分析确定手术时间与并发症之间的关系。
共有 105/336 例患者发生与手术相关的 AE，其中肿瘤组占 38%，退行性组占 28%。手术时的平均年龄为 60.3 岁（标准差 17.1），平均手术时间为 164.8±138 分钟。共记录了 206 起不良事件（30 起术中，135 起早期术后，41 起晚期术后）。早期术后并发症占记录不良事件的多数（肿瘤组占 55.5%，退行性组占 73.2%）。单变量逻辑回归分析证实，手术时间与术中（p 值=0.0008）、早期术后（p 值<0.001）和晚期术后（p 值<0.001）不良事件的风险增加相关。
本研究强调了脊柱外科手术中不良事件的发生与手术时间延长之间的强烈相关性，并表明应努力尽量缩短手术过程的持续时间，同时优先考虑患者的安全，而不影响手术技术的实现。
