Risk Factors for Medical Complication After Lumbar Spine Surgery: A Multivariate Analysis of 767 Patients

Multivariate analysis of prospectively collected registry data. Using multivariate analysis to determine significant risk factors for medical complication after lumbar spine surgery. Several studies have examined the occurrence of medical complication after spine surgery. However, many of these stud...

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Veröffentlicht in:Spine (Philadelphia, Pa. 1976) Pa. 1976), 2011-10, Vol.36 (21), p.1801-1806
Hauptverfasser: LEE, Michael J, HACQUEBORD, Jacques, VARSHNEY, Anuj, CIZIK, Amy M, BRANSFORD, Richard J, BELLABARBA, Carlo, KONODI, Mark A, CHAPMAN, Jens
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container_end_page 1806
container_issue 21
container_start_page 1801
container_title Spine (Philadelphia, Pa. 1976)
container_volume 36
creator LEE, Michael J
HACQUEBORD, Jacques
VARSHNEY, Anuj
CIZIK, Amy M
BRANSFORD, Richard J
BELLABARBA, Carlo
KONODI, Mark A
CHAPMAN, Jens
description Multivariate analysis of prospectively collected registry data. Using multivariate analysis to determine significant risk factors for medical complication after lumbar spine surgery. Several studies have examined the occurrence of medical complication after spine surgery. However, many of these studies have been done utilizing large national databases. Although these allow for analysis of thousands of patients, potentially influential covariates are not accounted for in these retrospective studies. Furthermore, the accuracy of these retrospective data collection in these databases has been called into question. The Spine End Results Registry (2003–2004) is a collection of prospectively collected data on all patients who underwent spine surgery at our two institutions. Extensive demographic and medical information were prospectively recorded as described previously by Mirza et al. Complications were defined in detail a priori and were prospectively recorded for at least 2 years after surgery. We analyzed risk factors for medical complication after lumbar spine surgery using univariate and multivariate analysis. We analyzed data from 767 patients who met out inclusion criteria. The cumulative incidences of complication after lumbar spine surgery per organ system are as follows: cardiac, 13%; pulmonary, 7%; gastrointestinal, 6.7%; neurological, 8.2%; hematological, 17.5%; and urologic complications, 10.3%. The occurrence of cardiac or respiratory complication after lumbar spine surgery was significantly associated with death within 2 years (relative risk: 6.09 and 10.9, respectively). Several significant risk factors were identified for organ-specific complications. Among these, surgical invasiveness appeared to be the largest risk factor for cardiac, pulmonary, neurological, and hematological complications. Risk factors identified in this study can be beneficial to clinicians and patients alike when considering surgical treatment of the lumbar spine. Future analyses and models that predict the occurrence of medical complication after lumbar spine surgery may be of further benefit for surgical decision making.
doi_str_mv 10.1097/BRS.0b013e318219d28d
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Using multivariate analysis to determine significant risk factors for medical complication after lumbar spine surgery. Several studies have examined the occurrence of medical complication after spine surgery. However, many of these studies have been done utilizing large national databases. Although these allow for analysis of thousands of patients, potentially influential covariates are not accounted for in these retrospective studies. Furthermore, the accuracy of these retrospective data collection in these databases has been called into question. The Spine End Results Registry (2003–2004) is a collection of prospectively collected data on all patients who underwent spine surgery at our two institutions. Extensive demographic and medical information were prospectively recorded as described previously by Mirza et al. Complications were defined in detail a priori and were prospectively recorded for at least 2 years after surgery. 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Future analyses and models that predict the occurrence of medical complication after lumbar spine surgery may be of further benefit for surgical decision making.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott Williams &amp; Wilkins</pub><pmid>22046614</pmid><doi>10.1097/BRS.0b013e318219d28d</doi><tpages>6</tpages></addata></record>
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ispartof Spine (Philadelphia, Pa. 1976), 2011-10, Vol.36 (21), p.1801-1806
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source MEDLINE; Journals@Ovid Complete
subjects Adolescent
Adult
Aged
Biological and medical sciences
Cerebrospinal fluid. Meninges. Spinal cord
Chi-Square Distribution
Decision Support Techniques
Female
Humans
Lumbar Vertebrae - surgery
Male
Medical sciences
Middle Aged
Multiple sclerosis and variants. Guillain barré syndrome and other inflammatory polyneuropathies. Leukoencephalitis
Multivariate Analysis
Nervous system (semeiology, syndromes)
Neurology
Orthopedic Procedures - adverse effects
Patient Selection
Postoperative Complications - etiology
Prospective Studies
Registries
Risk Assessment
Risk Factors
Time Factors
Treatment Outcome
Washington
Young Adult
title Risk Factors for Medical Complication After Lumbar Spine Surgery: A Multivariate Analysis of 767 Patients
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