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 |
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container_title | Spine (Philadelphia, Pa. 1976) |
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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. 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.</description><identifier>ISSN: 0362-2436</identifier><identifier>EISSN: 1528-1159</identifier><identifier>DOI: 10.1097/BRS.0b013e318219d28d</identifier><identifier>PMID: 22046614</identifier><identifier>CODEN: SPINDD</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott Williams & Wilkins</publisher><subject>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</subject><ispartof>Spine (Philadelphia, Pa. 1976), 2011-10, Vol.36 (21), p.1801-1806</ispartof><rights>2015 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c369t-50ed221ba30c4d3d07b3df0d1d092385211372431bcbf8b135ee24f2d97c06c43</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,885,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=24572875$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22046614$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>LEE, Michael J</creatorcontrib><creatorcontrib>HACQUEBORD, Jacques</creatorcontrib><creatorcontrib>VARSHNEY, Anuj</creatorcontrib><creatorcontrib>CIZIK, Amy M</creatorcontrib><creatorcontrib>BRANSFORD, Richard J</creatorcontrib><creatorcontrib>BELLABARBA, Carlo</creatorcontrib><creatorcontrib>KONODI, Mark A</creatorcontrib><creatorcontrib>CHAPMAN, Jens</creatorcontrib><title>Risk Factors for Medical Complication After Lumbar Spine Surgery: A Multivariate Analysis of 767 Patients</title><title>Spine (Philadelphia, Pa. 1976)</title><addtitle>Spine (Phila Pa 1976)</addtitle><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.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Biological and medical sciences</subject><subject>Cerebrospinal fluid. Meninges. Spinal cord</subject><subject>Chi-Square Distribution</subject><subject>Decision Support Techniques</subject><subject>Female</subject><subject>Humans</subject><subject>Lumbar Vertebrae - surgery</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Multiple sclerosis and variants. Guillain barré syndrome and other inflammatory polyneuropathies. Leukoencephalitis</subject><subject>Multivariate Analysis</subject><subject>Nervous system (semeiology, syndromes)</subject><subject>Neurology</subject><subject>Orthopedic Procedures - adverse effects</subject><subject>Patient Selection</subject><subject>Postoperative Complications - etiology</subject><subject>Prospective Studies</subject><subject>Registries</subject><subject>Risk Assessment</subject><subject>Risk Factors</subject><subject>Time Factors</subject><subject>Treatment Outcome</subject><subject>Washington</subject><subject>Young Adult</subject><issn>0362-2436</issn><issn>1528-1159</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkU1v1DAQhi0EokvhHyDkC-KUMmM7ccIBaVnRgrQVqAtny_FHMSTxYieV9t_jqkv5OI2leeadsR5CniOcIXTy9bur3Rn0gNxxbBl2lrX2AVlhzdoKse4ekhXwhlVM8OaEPMn5OwA0HLvH5IQxEE2DYkXCVcg_6Lk2c0yZ-pjopbPB6IFu4rgfymsOcaJrP7tEt8vY60R3-zA5ulvStUuHN3RNL5dhDjc6BT07up70cMgh0-ipbCT9XBLcNOen5JHXQ3bPjvWUfD1__2Xzodp-uvi4WW8rw5turmpwljHsNQcjLLcge249WLTQMd7WDJHL8ifsTe_bHnntHBOe2U4aaIzgp-TtXe5-6UdnTdmd9KD2KYw6HVTUQf3bmcI3dR1vFJeIAusS8OoYkOLPxeVZjSEbNwx6cnHJqgMGbSM5K6S4I02KOSfn77cgqFtJqkhS_0sqYy_-vvB-6LeVArw8AjoXFT7pyYT8hxO1ZK2s-S-OJJwN</recordid><startdate>20111001</startdate><enddate>20111001</enddate><creator>LEE, Michael J</creator><creator>HACQUEBORD, Jacques</creator><creator>VARSHNEY, Anuj</creator><creator>CIZIK, Amy M</creator><creator>BRANSFORD, Richard J</creator><creator>BELLABARBA, Carlo</creator><creator>KONODI, Mark A</creator><creator>CHAPMAN, Jens</creator><general>Lippincott Williams & Wilkins</general><scope>IQODW</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><scope>5PM</scope></search><sort><creationdate>20111001</creationdate><title>Risk Factors for Medical Complication After Lumbar Spine Surgery: A Multivariate Analysis of 767 Patients</title><author>LEE, Michael J ; HACQUEBORD, Jacques ; VARSHNEY, Anuj ; CIZIK, Amy M ; BRANSFORD, Richard J ; BELLABARBA, Carlo ; KONODI, Mark A ; CHAPMAN, Jens</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c369t-50ed221ba30c4d3d07b3df0d1d092385211372431bcbf8b135ee24f2d97c06c43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Biological and medical sciences</topic><topic>Cerebrospinal fluid. Meninges. Spinal cord</topic><topic>Chi-Square Distribution</topic><topic>Decision Support Techniques</topic><topic>Female</topic><topic>Humans</topic><topic>Lumbar Vertebrae - surgery</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Multiple sclerosis and variants. Guillain barré syndrome and other inflammatory polyneuropathies. Leukoencephalitis</topic><topic>Multivariate Analysis</topic><topic>Nervous system (semeiology, syndromes)</topic><topic>Neurology</topic><topic>Orthopedic Procedures - adverse effects</topic><topic>Patient Selection</topic><topic>Postoperative Complications - etiology</topic><topic>Prospective Studies</topic><topic>Registries</topic><topic>Risk Assessment</topic><topic>Risk Factors</topic><topic>Time Factors</topic><topic>Treatment Outcome</topic><topic>Washington</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>LEE, Michael J</creatorcontrib><creatorcontrib>HACQUEBORD, Jacques</creatorcontrib><creatorcontrib>VARSHNEY, Anuj</creatorcontrib><creatorcontrib>CIZIK, Amy M</creatorcontrib><creatorcontrib>BRANSFORD, Richard J</creatorcontrib><creatorcontrib>BELLABARBA, Carlo</creatorcontrib><creatorcontrib>KONODI, Mark A</creatorcontrib><creatorcontrib>CHAPMAN, Jens</creatorcontrib><collection>Pascal-Francis</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><collection>PubMed Central (Full Participant titles)</collection><jtitle>Spine (Philadelphia, Pa. 1976)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>LEE, Michael J</au><au>HACQUEBORD, Jacques</au><au>VARSHNEY, Anuj</au><au>CIZIK, Amy M</au><au>BRANSFORD, Richard J</au><au>BELLABARBA, Carlo</au><au>KONODI, Mark A</au><au>CHAPMAN, Jens</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Risk Factors for Medical Complication After Lumbar Spine Surgery: A Multivariate Analysis of 767 Patients</atitle><jtitle>Spine (Philadelphia, Pa. 1976)</jtitle><addtitle>Spine (Phila Pa 1976)</addtitle><date>2011-10-01</date><risdate>2011</risdate><volume>36</volume><issue>21</issue><spage>1801</spage><epage>1806</epage><pages>1801-1806</pages><issn>0362-2436</issn><eissn>1528-1159</eissn><coden>SPINDD</coden><abstract>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.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott Williams & Wilkins</pub><pmid>22046614</pmid><doi>10.1097/BRS.0b013e318219d28d</doi><tpages>6</tpages></addata></record> |
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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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