Thirty-day unplanned reoperations of thoracic spine surgery: 10 years of data from a single center with 3242 patients

•The incidence of 30-day unplanned reoperations in 3242 patients with thoracic spine disease was 3.30% based on a single center from 2012 to 2021.•The chief causes for reoperation within 30 days after thoracic spine surgery included epidural hematoma, wound complications, implant complications, and...

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Veröffentlicht in:The spine journal 2023-05, Vol.23 (5), p.703-714
Hauptverfasser: Hu, Yuanyu, Ouyang, Hanqiang, Ye, Kaifeng, Dong, Yanlei, Zhang, Xin, Dong, Shu, Chen, Zhongqiang, Liu, Zhongjun, Liu, Xiaoguang, Zeng, Yan, Wei, Feng, Sun, Chuiguo, Tian, Yun, Li, Weishi
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container_end_page 714
container_issue 5
container_start_page 703
container_title The spine journal
container_volume 23
creator Hu, Yuanyu
Ouyang, Hanqiang
Ye, Kaifeng
Dong, Yanlei
Zhang, Xin
Dong, Shu
Chen, Zhongqiang
Liu, Zhongjun
Liu, Xiaoguang
Zeng, Yan
Wei, Feng
Sun, Chuiguo
Tian, Yun
Li, Weishi
description •The incidence of 30-day unplanned reoperations in 3242 patients with thoracic spine disease was 3.30% based on a single center from 2012 to 2021.•The chief causes for reoperation within 30 days after thoracic spine surgery included epidural hematoma, wound complications, implant complications, and inadequate decompression.•Upper thoracic spine surgery, concomitant dekyphosis, underlying coagulation disorder, longer operation time, higher ASA grade and pathological diagnosis of ankylosing spondylitis led to an increased risk of 30-day unplanned reoperation after primary surgery for a specific thoracic spine disease. Unplanned reoperation is a useful quality indicator for spine surgery. However, the rates of a 30-day unplanned reoperation in patients undergoing thoracic spinal surgery are not well established. To assess the rates, reasons, and risk factors of 30-day unplanned reoperations for thoracic spine surgeries in a single center study. A retrospective observational study. A total of 3242 patients who underwent thoracic spinal surgery at our institution in the past decade were included. The incidence, chief reasons, and risk factors for unplanned reoperations within 30 days after thoracic spinal surgery. We retrospectively analyzed the data of all patients who underwent thoracic spinal surgery between January 2012 and December 2021. Statistical methods, including univariate and multivariate analyses, were performed to assess the incidence, reasons, and risk factors for thoracic degenerative diseases, spinal tumors, kyphosis deformity, and spinal trauma. Of the 3242 patients who underwent thoracic spinal surgery, 107 (3.30%) required unplanned reoperations within 30 days due to epidural hematoma (1.17%), wound complications (0.80%), implant complications (0.43%), inadequate decompression (0.25%), and other causes (0.65%). Patients with degenerative disease (3.88%), spinal tumor (2.98%), and kyphosis deformity (3.33%) had significantly higher incidences of reoperation than those with spinal trauma (1.47%). Unplanned reoperations were classified as hyperacute (30.84%), acute (31.76%), and subacute (37.38%). After univariate analysis, several factors were associated with unplanned reoperation in the 4 cohorts of thoracic spine diseases (p
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Unplanned reoperation is a useful quality indicator for spine surgery. However, the rates of a 30-day unplanned reoperation in patients undergoing thoracic spinal surgery are not well established. To assess the rates, reasons, and risk factors of 30-day unplanned reoperations for thoracic spine surgeries in a single center study. A retrospective observational study. A total of 3242 patients who underwent thoracic spinal surgery at our institution in the past decade were included. The incidence, chief reasons, and risk factors for unplanned reoperations within 30 days after thoracic spinal surgery. We retrospectively analyzed the data of all patients who underwent thoracic spinal surgery between January 2012 and December 2021. Statistical methods, including univariate and multivariate analyses, were performed to assess the incidence, reasons, and risk factors for thoracic degenerative diseases, spinal tumors, kyphosis deformity, and spinal trauma. Of the 3242 patients who underwent thoracic spinal surgery, 107 (3.30%) required unplanned reoperations within 30 days due to epidural hematoma (1.17%), wound complications (0.80%), implant complications (0.43%), inadequate decompression (0.25%), and other causes (0.65%). Patients with degenerative disease (3.88%), spinal tumor (2.98%), and kyphosis deformity (3.33%) had significantly higher incidences of reoperation than those with spinal trauma (1.47%). Unplanned reoperations were classified as hyperacute (30.84%), acute (31.76%), and subacute (37.38%). After univariate analysis, several factors were associated with unplanned reoperation in the 4 cohorts of thoracic spine diseases (p&lt;.05). Multivariate logistic regression analysis revealed that upper thoracic spine surgery (p=.001), concomitant dekyphosis (p=.027), and longer activated partial thromboplastin time (p=.025) were risk factors of unplanned reoperation for thoracic degenerative disease. Whereas American Society of Anesthesiologists (ASA) grade III (p=.015), combined approach (p=.016), and operation time longer than 420 min (p=.042) for spinal tumor, and similar ankylosing spondylitis (p=.023) and operation time longer than 340 min (p=.041) were risk factors of unplanned reoperation for kyphosis deformity. The unplanned reoperation rate for thoracic spine surgery was 3.30%, with epidural hematoma and wound complications being the most common reasons. However, upper thoracic spine surgery, concomitant dekyphosis, underlying coagulation disorder, longer operation time, higher ASA grade, and comorbidities of ankylosing spondylitis led to an increased risk of unplanned reoperation within 30 days of thoracic spine surgery.</description><identifier>ISSN: 1529-9430</identifier><identifier>EISSN: 1878-1632</identifier><identifier>DOI: 10.1016/j.spinee.2023.01.005</identifier><identifier>PMID: 36641036</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Complications ; Degenerative disease ; Hematoma - surgery ; Humans ; Incidences ; Kyphosis - epidemiology ; Kyphosis - surgery ; Kyphosis deformity ; Postoperative Complications - epidemiology ; Postoperative Complications - surgery ; Reoperation ; Retrospective Studies ; Risk factor ; Spinal Injuries - surgery ; Spinal Neoplasms - surgery ; Spondylitis, Ankylosing - surgery ; Thoracic spinal surgery ; Trauma ; Tumor ; Unplanned reoperation</subject><ispartof>The spine journal, 2023-05, Vol.23 (5), p.703-714</ispartof><rights>2023 The Author(s)</rights><rights>Copyright © 2023 The Author(s). Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c357t-59fb91edc824e268f692f697ce939aeb7409f380071b4b0de05ed9e47159c6863</cites><orcidid>0000-0003-2310-6054 ; 0000-0002-6595-1910 ; 0000-0001-9512-5436 ; 0000-0001-8397-6567</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S1529943023000062$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>314,776,780,3536,27903,27904,65309</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36641036$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hu, Yuanyu</creatorcontrib><creatorcontrib>Ouyang, Hanqiang</creatorcontrib><creatorcontrib>Ye, Kaifeng</creatorcontrib><creatorcontrib>Dong, Yanlei</creatorcontrib><creatorcontrib>Zhang, Xin</creatorcontrib><creatorcontrib>Dong, Shu</creatorcontrib><creatorcontrib>Chen, Zhongqiang</creatorcontrib><creatorcontrib>Liu, Zhongjun</creatorcontrib><creatorcontrib>Liu, Xiaoguang</creatorcontrib><creatorcontrib>Zeng, Yan</creatorcontrib><creatorcontrib>Wei, Feng</creatorcontrib><creatorcontrib>Sun, Chuiguo</creatorcontrib><creatorcontrib>Tian, Yun</creatorcontrib><creatorcontrib>Li, Weishi</creatorcontrib><title>Thirty-day unplanned reoperations of thoracic spine surgery: 10 years of data from a single center with 3242 patients</title><title>The spine journal</title><addtitle>Spine J</addtitle><description>•The incidence of 30-day unplanned reoperations in 3242 patients with thoracic spine disease was 3.30% based on a single center from 2012 to 2021.•The chief causes for reoperation within 30 days after thoracic spine surgery included epidural hematoma, wound complications, implant complications, and inadequate decompression.•Upper thoracic spine surgery, concomitant dekyphosis, underlying coagulation disorder, longer operation time, higher ASA grade and pathological diagnosis of ankylosing spondylitis led to an increased risk of 30-day unplanned reoperation after primary surgery for a specific thoracic spine disease. Unplanned reoperation is a useful quality indicator for spine surgery. However, the rates of a 30-day unplanned reoperation in patients undergoing thoracic spinal surgery are not well established. To assess the rates, reasons, and risk factors of 30-day unplanned reoperations for thoracic spine surgeries in a single center study. A retrospective observational study. A total of 3242 patients who underwent thoracic spinal surgery at our institution in the past decade were included. The incidence, chief reasons, and risk factors for unplanned reoperations within 30 days after thoracic spinal surgery. We retrospectively analyzed the data of all patients who underwent thoracic spinal surgery between January 2012 and December 2021. Statistical methods, including univariate and multivariate analyses, were performed to assess the incidence, reasons, and risk factors for thoracic degenerative diseases, spinal tumors, kyphosis deformity, and spinal trauma. Of the 3242 patients who underwent thoracic spinal surgery, 107 (3.30%) required unplanned reoperations within 30 days due to epidural hematoma (1.17%), wound complications (0.80%), implant complications (0.43%), inadequate decompression (0.25%), and other causes (0.65%). Patients with degenerative disease (3.88%), spinal tumor (2.98%), and kyphosis deformity (3.33%) had significantly higher incidences of reoperation than those with spinal trauma (1.47%). Unplanned reoperations were classified as hyperacute (30.84%), acute (31.76%), and subacute (37.38%). After univariate analysis, several factors were associated with unplanned reoperation in the 4 cohorts of thoracic spine diseases (p&lt;.05). Multivariate logistic regression analysis revealed that upper thoracic spine surgery (p=.001), concomitant dekyphosis (p=.027), and longer activated partial thromboplastin time (p=.025) were risk factors of unplanned reoperation for thoracic degenerative disease. Whereas American Society of Anesthesiologists (ASA) grade III (p=.015), combined approach (p=.016), and operation time longer than 420 min (p=.042) for spinal tumor, and similar ankylosing spondylitis (p=.023) and operation time longer than 340 min (p=.041) were risk factors of unplanned reoperation for kyphosis deformity. The unplanned reoperation rate for thoracic spine surgery was 3.30%, with epidural hematoma and wound complications being the most common reasons. However, upper thoracic spine surgery, concomitant dekyphosis, underlying coagulation disorder, longer operation time, higher ASA grade, and comorbidities of ankylosing spondylitis led to an increased risk of unplanned reoperation within 30 days of thoracic spine surgery.</description><subject>Complications</subject><subject>Degenerative disease</subject><subject>Hematoma - surgery</subject><subject>Humans</subject><subject>Incidences</subject><subject>Kyphosis - epidemiology</subject><subject>Kyphosis - surgery</subject><subject>Kyphosis deformity</subject><subject>Postoperative Complications - epidemiology</subject><subject>Postoperative Complications - surgery</subject><subject>Reoperation</subject><subject>Retrospective Studies</subject><subject>Risk factor</subject><subject>Spinal Injuries - surgery</subject><subject>Spinal Neoplasms - surgery</subject><subject>Spondylitis, Ankylosing - surgery</subject><subject>Thoracic spinal surgery</subject><subject>Trauma</subject><subject>Tumor</subject><subject>Unplanned reoperation</subject><issn>1529-9430</issn><issn>1878-1632</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kMFu1DAQhi1ERUvhDRDykUvC2E7smAMSqlpAqsSlPVuOPel6tRsH2wHl7XG7hSOHkUfWN_NrPkLeMWgZMPlx3-YlzIgtBy5aYC1A_4JcsEENDZOCv6x9z3WjOwHn5HXOewAYFOOvyLmQsmMg5AVZ73Yhla3xdqPrvBzsPKOnCeOCyZYQ50zjRMsuJuuCo0-RNK_pAdP2iTKgG9r0xHhbLJ1SPFJLc5gfDkgdzgUT_R3KjgrecbrUlfUvvyFnkz1kfPv8XpL7m-u7q2_N7Y-v36--3DZO9Ko0vZ5GzdC7gXfI5TBJzWsph1poi6PqQE9iAFBs7EbwCD16jZ1ivXZykOKSfDjtXVL8uWIu5hiyw0M9E-OaDVeyV0pzYBXtTqhLMeeEk1lSONq0GQbmUbjZm5Nw8yjcADNVeB17_5ywjkf0_4b-Gq7A5xOA9c5fAZPJrjpw6ENCV4yP4f8JfwCBupOe</recordid><startdate>202305</startdate><enddate>202305</enddate><creator>Hu, Yuanyu</creator><creator>Ouyang, Hanqiang</creator><creator>Ye, Kaifeng</creator><creator>Dong, Yanlei</creator><creator>Zhang, Xin</creator><creator>Dong, Shu</creator><creator>Chen, Zhongqiang</creator><creator>Liu, Zhongjun</creator><creator>Liu, Xiaoguang</creator><creator>Zeng, Yan</creator><creator>Wei, Feng</creator><creator>Sun, Chuiguo</creator><creator>Tian, Yun</creator><creator>Li, Weishi</creator><general>Elsevier Inc</general><scope>6I.</scope><scope>AAFTH</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-2310-6054</orcidid><orcidid>https://orcid.org/0000-0002-6595-1910</orcidid><orcidid>https://orcid.org/0000-0001-9512-5436</orcidid><orcidid>https://orcid.org/0000-0001-8397-6567</orcidid></search><sort><creationdate>202305</creationdate><title>Thirty-day unplanned reoperations of thoracic spine surgery: 10 years of data from a single center with 3242 patients</title><author>Hu, Yuanyu ; Ouyang, Hanqiang ; Ye, Kaifeng ; Dong, Yanlei ; Zhang, Xin ; Dong, Shu ; Chen, Zhongqiang ; Liu, Zhongjun ; Liu, Xiaoguang ; Zeng, Yan ; Wei, Feng ; Sun, Chuiguo ; Tian, Yun ; Li, Weishi</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c357t-59fb91edc824e268f692f697ce939aeb7409f380071b4b0de05ed9e47159c6863</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Complications</topic><topic>Degenerative disease</topic><topic>Hematoma - surgery</topic><topic>Humans</topic><topic>Incidences</topic><topic>Kyphosis - epidemiology</topic><topic>Kyphosis - surgery</topic><topic>Kyphosis deformity</topic><topic>Postoperative Complications - epidemiology</topic><topic>Postoperative Complications - surgery</topic><topic>Reoperation</topic><topic>Retrospective Studies</topic><topic>Risk factor</topic><topic>Spinal Injuries - surgery</topic><topic>Spinal Neoplasms - surgery</topic><topic>Spondylitis, Ankylosing - surgery</topic><topic>Thoracic spinal surgery</topic><topic>Trauma</topic><topic>Tumor</topic><topic>Unplanned reoperation</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hu, Yuanyu</creatorcontrib><creatorcontrib>Ouyang, Hanqiang</creatorcontrib><creatorcontrib>Ye, Kaifeng</creatorcontrib><creatorcontrib>Dong, Yanlei</creatorcontrib><creatorcontrib>Zhang, Xin</creatorcontrib><creatorcontrib>Dong, Shu</creatorcontrib><creatorcontrib>Chen, Zhongqiang</creatorcontrib><creatorcontrib>Liu, Zhongjun</creatorcontrib><creatorcontrib>Liu, Xiaoguang</creatorcontrib><creatorcontrib>Zeng, Yan</creatorcontrib><creatorcontrib>Wei, Feng</creatorcontrib><creatorcontrib>Sun, Chuiguo</creatorcontrib><creatorcontrib>Tian, Yun</creatorcontrib><creatorcontrib>Li, Weishi</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The spine journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hu, Yuanyu</au><au>Ouyang, Hanqiang</au><au>Ye, Kaifeng</au><au>Dong, Yanlei</au><au>Zhang, Xin</au><au>Dong, Shu</au><au>Chen, Zhongqiang</au><au>Liu, Zhongjun</au><au>Liu, Xiaoguang</au><au>Zeng, Yan</au><au>Wei, Feng</au><au>Sun, Chuiguo</au><au>Tian, Yun</au><au>Li, Weishi</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Thirty-day unplanned reoperations of thoracic spine surgery: 10 years of data from a single center with 3242 patients</atitle><jtitle>The spine journal</jtitle><addtitle>Spine J</addtitle><date>2023-05</date><risdate>2023</risdate><volume>23</volume><issue>5</issue><spage>703</spage><epage>714</epage><pages>703-714</pages><issn>1529-9430</issn><eissn>1878-1632</eissn><abstract>•The incidence of 30-day unplanned reoperations in 3242 patients with thoracic spine disease was 3.30% based on a single center from 2012 to 2021.•The chief causes for reoperation within 30 days after thoracic spine surgery included epidural hematoma, wound complications, implant complications, and inadequate decompression.•Upper thoracic spine surgery, concomitant dekyphosis, underlying coagulation disorder, longer operation time, higher ASA grade and pathological diagnosis of ankylosing spondylitis led to an increased risk of 30-day unplanned reoperation after primary surgery for a specific thoracic spine disease. Unplanned reoperation is a useful quality indicator for spine surgery. However, the rates of a 30-day unplanned reoperation in patients undergoing thoracic spinal surgery are not well established. To assess the rates, reasons, and risk factors of 30-day unplanned reoperations for thoracic spine surgeries in a single center study. A retrospective observational study. A total of 3242 patients who underwent thoracic spinal surgery at our institution in the past decade were included. The incidence, chief reasons, and risk factors for unplanned reoperations within 30 days after thoracic spinal surgery. We retrospectively analyzed the data of all patients who underwent thoracic spinal surgery between January 2012 and December 2021. Statistical methods, including univariate and multivariate analyses, were performed to assess the incidence, reasons, and risk factors for thoracic degenerative diseases, spinal tumors, kyphosis deformity, and spinal trauma. Of the 3242 patients who underwent thoracic spinal surgery, 107 (3.30%) required unplanned reoperations within 30 days due to epidural hematoma (1.17%), wound complications (0.80%), implant complications (0.43%), inadequate decompression (0.25%), and other causes (0.65%). Patients with degenerative disease (3.88%), spinal tumor (2.98%), and kyphosis deformity (3.33%) had significantly higher incidences of reoperation than those with spinal trauma (1.47%). Unplanned reoperations were classified as hyperacute (30.84%), acute (31.76%), and subacute (37.38%). After univariate analysis, several factors were associated with unplanned reoperation in the 4 cohorts of thoracic spine diseases (p&lt;.05). Multivariate logistic regression analysis revealed that upper thoracic spine surgery (p=.001), concomitant dekyphosis (p=.027), and longer activated partial thromboplastin time (p=.025) were risk factors of unplanned reoperation for thoracic degenerative disease. Whereas American Society of Anesthesiologists (ASA) grade III (p=.015), combined approach (p=.016), and operation time longer than 420 min (p=.042) for spinal tumor, and similar ankylosing spondylitis (p=.023) and operation time longer than 340 min (p=.041) were risk factors of unplanned reoperation for kyphosis deformity. The unplanned reoperation rate for thoracic spine surgery was 3.30%, with epidural hematoma and wound complications being the most common reasons. However, upper thoracic spine surgery, concomitant dekyphosis, underlying coagulation disorder, longer operation time, higher ASA grade, and comorbidities of ankylosing spondylitis led to an increased risk of unplanned reoperation within 30 days of thoracic spine surgery.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>36641036</pmid><doi>10.1016/j.spinee.2023.01.005</doi><tpages>12</tpages><orcidid>https://orcid.org/0000-0003-2310-6054</orcidid><orcidid>https://orcid.org/0000-0002-6595-1910</orcidid><orcidid>https://orcid.org/0000-0001-9512-5436</orcidid><orcidid>https://orcid.org/0000-0001-8397-6567</orcidid><oa>free_for_read</oa></addata></record>
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subjects Complications
Degenerative disease
Hematoma - surgery
Humans
Incidences
Kyphosis - epidemiology
Kyphosis - surgery
Kyphosis deformity
Postoperative Complications - epidemiology
Postoperative Complications - surgery
Reoperation
Retrospective Studies
Risk factor
Spinal Injuries - surgery
Spinal Neoplasms - surgery
Spondylitis, Ankylosing - surgery
Thoracic spinal surgery
Trauma
Tumor
Unplanned reoperation
title Thirty-day unplanned reoperations of thoracic spine surgery: 10 years of data from a single center with 3242 patients
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