Analysis of Inpatient Complications in Neurosurgery

We retrospectively analyzed the one-year complication rates and preventable deaths associated with neurosurgical treatment. We analyzed data from inpatients who were admitted to a medium-scale, 376-bed, acute-care hospital in 2013. Of the 413 admitted patients, 215 underwent neurosurgical interventions (including 54 endovascular procedures), and 22 died (5.3%). Recently, the average age of admitted patients has increased, and advanced age is more prevalent in fatal cases. In half of the deaths that occurred during hospitalization, the cause of death was not a complication of the primary disease. In 18.2%, infectious complications were the cause of death. Of the 3 cases of acute cardiac failure that were analyzed, 2 had a suspected pulmonary embolism. Using D-dimer screening tests, deep venous thrombosis was diagnosed in 3.1% of all patients and was diagnosed in more than 6% of subarachnoid hemorrhage and intracerebral hemorrhage cases. As for surgical site infections, antibiotics other than cefazolin were used in 12.9% of all cases perioperatively. In 20.2% of cerebral angiography and 47.6% of surgical cases, microorganisms were recovered at the end of the procedure from the disinfected area. Patient safety must be secured not only with proper surgical techniques but also with appropriate perioperative management. These findings clearly indicate that establishing an evidence-based acute care system is requisite for patient safety even in the field of neurosurgery.