Predictive Analytics for Determining Extended Operative Time in Corrective Adult Spinal Deformity Surgery
More sophisticated surgical techniques for correcting adult spinal deformity (ASD) have increased operative times, adding to physiologic stress on patients and increased complication incidence. This study aims to determine factors associated with operative time using a statistical learning algorithm...
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| Veröffentlicht in: | International journal of spine surgery 2022-04, Vol.16 (2), p.291-299 |
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| creator | Passias, Peter G Poorman, Gregory W Vasquez-Montes, Dennis Kummer, Nicholas Mundis, Gregory Anand, Neel Horn, Samantha R Segreto, Frank A Passfall, Lara Krol, Oscar Diebo, Bassel Burton, Doug Buckland, Aaron Gerling, Michael Soroceanu, Alex Eastlack, Robert Kojo Hamilton, D Hart, Robert Schwab, Frank Lafage, Virginie Shaffrey, Christopher Sciubba, Daniel Bess, Shay Ames, Christopher Klineberg, Eric |
| description | More sophisticated surgical techniques for correcting adult spinal deformity (ASD) have increased operative times, adding to physiologic stress on patients and increased complication incidence. This study aims to determine factors associated with operative time using a statistical learning algorithm.
Retrospective review of a prospective multicenter database containing 837 patients undergoing long spinal fusions for ASD. Conditional inference decision trees identified factors associated with skin-to-skin operative time and cutoff points at which factors have a global effect. A conditional variable-importance table was constructed based on a nonreplacement sampling set of 2000 conditional inference trees. Means comparison for the top 15 variables at their respective significant cutoffs indicated effect sizes.
Included: 544 surgical ASD patients (mean age: 58.0 years; fusion length 11.3 levels; operative time: 378 minutes). The strongest predictor for operative time was institution/surgeon. Center/surgeons, grouped by decision tree hierarchy, a and b were, on average, 2 hours faster than center/surgeons c-f, who were 43 minutes faster than centers g-j, all
< 0.001. The next most important predictors were, in order, approach (combined vs posterior increases time by 139 minutes,
< 0.001), levels fused ( |
| doi_str_mv | 10.14444/8174 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_9930651</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2653267738</sourcerecordid><originalsourceid>FETCH-LOGICAL-c2784-4990184ab3e9bf5310afa6207fb809a43c9bea1dbed45bf7e0916e605bbbde1d3</originalsourceid><addsrcrecordid>eNpVkctKAzEUhoMottS-gmQjuKkmk7llI5RaL1Co0LoOyeRMjczNJFOct3dsa6nZnMD5_i-BH6ExJXc07M99SpPwDA2DgNJJGHF-fnIfoLFzn4QQShlPObtEAxb1IcLSITJvFrTJvNkCnlay6LzJHM5rix_Bgy1NZaoNnn97qDRovGzAyh28NiVgU-FZbS0c8rotPF41pvf08V5SGt_hVWs3YLsrdJHLwsH4MEfo_Wm-nr1MFsvn19l0McmCJA0nIeeEpqFUDLjKI0aJzGUckCRXKeEyZBlXIKlWoMNI5QkQTmOISaSU0kA1G6GHvbdpVQk6g8pbWYjGmlLaTtTSiP-bynyITb0VnDMSR7QX3B4Etv5qwXlRGpdBUcgK6taJII5YECcJS3v0Zo9mtnbOQn58hhKxa0b8NtNz16d_OlJ_PbAfBGqKgw</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2653267738</pqid></control><display><type>article</type><title>Predictive Analytics for Determining Extended Operative Time in Corrective Adult Spinal Deformity Surgery</title><source>PubMed Central</source><source>Alma/SFX Local Collection</source><creator>Passias, Peter G ; Poorman, Gregory W ; Vasquez-Montes, Dennis ; Kummer, Nicholas ; Mundis, Gregory ; Anand, Neel ; Horn, Samantha R ; Segreto, Frank A ; Passfall, Lara ; Krol, Oscar ; Diebo, Bassel ; Burton, Doug ; Buckland, Aaron ; Gerling, Michael ; Soroceanu, Alex ; Eastlack, Robert ; Kojo Hamilton, D ; Hart, Robert ; Schwab, Frank ; Lafage, Virginie ; Shaffrey, Christopher ; Sciubba, Daniel ; Bess, Shay ; Ames, Christopher ; Klineberg, Eric</creator><creatorcontrib>Passias, Peter G ; Poorman, Gregory W ; Vasquez-Montes, Dennis ; Kummer, Nicholas ; Mundis, Gregory ; Anand, Neel ; Horn, Samantha R ; Segreto, Frank A ; Passfall, Lara ; Krol, Oscar ; Diebo, Bassel ; Burton, Doug ; Buckland, Aaron ; Gerling, Michael ; Soroceanu, Alex ; Eastlack, Robert ; Kojo Hamilton, D ; Hart, Robert ; Schwab, Frank ; Lafage, Virginie ; Shaffrey, Christopher ; Sciubba, Daniel ; Bess, Shay ; Ames, Christopher ; Klineberg, Eric ; International Spine Study Group ; On behalf of the International Spine Study Group</creatorcontrib><description><![CDATA[More sophisticated surgical techniques for correcting adult spinal deformity (ASD) have increased operative times, adding to physiologic stress on patients and increased complication incidence. This study aims to determine factors associated with operative time using a statistical learning algorithm.
Retrospective review of a prospective multicenter database containing 837 patients undergoing long spinal fusions for ASD. Conditional inference decision trees identified factors associated with skin-to-skin operative time and cutoff points at which factors have a global effect. A conditional variable-importance table was constructed based on a nonreplacement sampling set of 2000 conditional inference trees. Means comparison for the top 15 variables at their respective significant cutoffs indicated effect sizes.
Included: 544 surgical ASD patients (mean age: 58.0 years; fusion length 11.3 levels; operative time: 378 minutes). The strongest predictor for operative time was institution/surgeon. Center/surgeons, grouped by decision tree hierarchy, a and b were, on average, 2 hours faster than center/surgeons c-f, who were 43 minutes faster than centers g-j, all
< 0.001. The next most important predictors were, in order, approach (combined vs posterior increases time by 139 minutes,
< 0.001), levels fused (<4 vs 5-9 increased time by 68 minutes,
< 0.050; 5-9 vs
10 increased time by 47 minutes,
< 0.001), age (age <50 years increases time by 57 minutes,
< 0.001), and patient frailty (score <1.54 increases time by 65 minutes,
< 0.001). Surgical techniques, such as three-column osteotomies (35 minutes), interbody device (45 minutes), and decompression (48 minutes), also increased operative time. Both minor and major complications correlated with
66 minutes of increased operative time. Increased operative time also correlated with increased hospital length of stay (LOS), increased estimated intraoperative blood loss (EBL), and inferior 2-year Oswestry Disability Index (ODI) scores.
Procedure location and specific surgeon are the most important factors determining operative time, accounting for operative time increases <2 hours. Surgical approach and number of levels fused were also associated with longer operative times, respectively. Extended operative time correlated with longer LOS, higher EBL, and inferior 2-y ODI outcomes.
We further identified the poor outcomes associated with extended operative time during surgical correction of ASD, and attributed the useful predictors of time spent in the operating room, including site, surgeon, surgical approach, and the number of levels fused.]]></description><identifier>ISSN: 2211-4599</identifier><identifier>EISSN: 2211-4599</identifier><identifier>DOI: 10.14444/8174</identifier><identifier>PMID: 35444038</identifier><language>eng</language><publisher>Netherlands: International Society for the Advancement of Spine Surgery</publisher><subject>Lumbar Spine</subject><ispartof>International journal of spine surgery, 2022-04, Vol.16 (2), p.291-299</ispartof><rights>This manuscript is generously published free of charge by ISASS, the International Society for the Advancement of Spine Surgery. Copyright © 2022 ISASS. To see more or order reprints or permissions, see http://ijssurgery.com.</rights><rights>This manuscript is generously published free of charge by ISASS, the International Society for the Advancement of Spine Surgery. Copyright © 2022 ISASS. To see more or order reprints or permissions, see . 2022</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c2784-4990184ab3e9bf5310afa6207fb809a43c9bea1dbed45bf7e0916e605bbbde1d3</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9930651/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9930651/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,723,776,780,881,27901,27902,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35444038$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Passias, Peter G</creatorcontrib><creatorcontrib>Poorman, Gregory W</creatorcontrib><creatorcontrib>Vasquez-Montes, Dennis</creatorcontrib><creatorcontrib>Kummer, Nicholas</creatorcontrib><creatorcontrib>Mundis, Gregory</creatorcontrib><creatorcontrib>Anand, Neel</creatorcontrib><creatorcontrib>Horn, Samantha R</creatorcontrib><creatorcontrib>Segreto, Frank A</creatorcontrib><creatorcontrib>Passfall, Lara</creatorcontrib><creatorcontrib>Krol, Oscar</creatorcontrib><creatorcontrib>Diebo, Bassel</creatorcontrib><creatorcontrib>Burton, Doug</creatorcontrib><creatorcontrib>Buckland, Aaron</creatorcontrib><creatorcontrib>Gerling, Michael</creatorcontrib><creatorcontrib>Soroceanu, Alex</creatorcontrib><creatorcontrib>Eastlack, Robert</creatorcontrib><creatorcontrib>Kojo Hamilton, D</creatorcontrib><creatorcontrib>Hart, Robert</creatorcontrib><creatorcontrib>Schwab, Frank</creatorcontrib><creatorcontrib>Lafage, Virginie</creatorcontrib><creatorcontrib>Shaffrey, Christopher</creatorcontrib><creatorcontrib>Sciubba, Daniel</creatorcontrib><creatorcontrib>Bess, Shay</creatorcontrib><creatorcontrib>Ames, Christopher</creatorcontrib><creatorcontrib>Klineberg, Eric</creatorcontrib><creatorcontrib>International Spine Study Group</creatorcontrib><creatorcontrib>On behalf of the International Spine Study Group</creatorcontrib><title>Predictive Analytics for Determining Extended Operative Time in Corrective Adult Spinal Deformity Surgery</title><title>International journal of spine surgery</title><addtitle>Int J Spine Surg</addtitle><description><![CDATA[More sophisticated surgical techniques for correcting adult spinal deformity (ASD) have increased operative times, adding to physiologic stress on patients and increased complication incidence. This study aims to determine factors associated with operative time using a statistical learning algorithm.
Retrospective review of a prospective multicenter database containing 837 patients undergoing long spinal fusions for ASD. Conditional inference decision trees identified factors associated with skin-to-skin operative time and cutoff points at which factors have a global effect. A conditional variable-importance table was constructed based on a nonreplacement sampling set of 2000 conditional inference trees. Means comparison for the top 15 variables at their respective significant cutoffs indicated effect sizes.
Included: 544 surgical ASD patients (mean age: 58.0 years; fusion length 11.3 levels; operative time: 378 minutes). The strongest predictor for operative time was institution/surgeon. Center/surgeons, grouped by decision tree hierarchy, a and b were, on average, 2 hours faster than center/surgeons c-f, who were 43 minutes faster than centers g-j, all
< 0.001. The next most important predictors were, in order, approach (combined vs posterior increases time by 139 minutes,
< 0.001), levels fused (<4 vs 5-9 increased time by 68 minutes,
< 0.050; 5-9 vs
10 increased time by 47 minutes,
< 0.001), age (age <50 years increases time by 57 minutes,
< 0.001), and patient frailty (score <1.54 increases time by 65 minutes,
< 0.001). Surgical techniques, such as three-column osteotomies (35 minutes), interbody device (45 minutes), and decompression (48 minutes), also increased operative time. Both minor and major complications correlated with
66 minutes of increased operative time. Increased operative time also correlated with increased hospital length of stay (LOS), increased estimated intraoperative blood loss (EBL), and inferior 2-year Oswestry Disability Index (ODI) scores.
Procedure location and specific surgeon are the most important factors determining operative time, accounting for operative time increases <2 hours. Surgical approach and number of levels fused were also associated with longer operative times, respectively. Extended operative time correlated with longer LOS, higher EBL, and inferior 2-y ODI outcomes.
We further identified the poor outcomes associated with extended operative time during surgical correction of ASD, and attributed the useful predictors of time spent in the operating room, including site, surgeon, surgical approach, and the number of levels fused.]]></description><subject>Lumbar Spine</subject><issn>2211-4599</issn><issn>2211-4599</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><recordid>eNpVkctKAzEUhoMottS-gmQjuKkmk7llI5RaL1Co0LoOyeRMjczNJFOct3dsa6nZnMD5_i-BH6ExJXc07M99SpPwDA2DgNJJGHF-fnIfoLFzn4QQShlPObtEAxb1IcLSITJvFrTJvNkCnlay6LzJHM5rix_Bgy1NZaoNnn97qDRovGzAyh28NiVgU-FZbS0c8rotPF41pvf08V5SGt_hVWs3YLsrdJHLwsH4MEfo_Wm-nr1MFsvn19l0McmCJA0nIeeEpqFUDLjKI0aJzGUckCRXKeEyZBlXIKlWoMNI5QkQTmOISaSU0kA1G6GHvbdpVQk6g8pbWYjGmlLaTtTSiP-bynyITb0VnDMSR7QX3B4Etv5qwXlRGpdBUcgK6taJII5YECcJS3v0Zo9mtnbOQn58hhKxa0b8NtNz16d_OlJ_PbAfBGqKgw</recordid><startdate>20220401</startdate><enddate>20220401</enddate><creator>Passias, Peter G</creator><creator>Poorman, Gregory W</creator><creator>Vasquez-Montes, Dennis</creator><creator>Kummer, Nicholas</creator><creator>Mundis, Gregory</creator><creator>Anand, Neel</creator><creator>Horn, Samantha R</creator><creator>Segreto, Frank A</creator><creator>Passfall, Lara</creator><creator>Krol, Oscar</creator><creator>Diebo, Bassel</creator><creator>Burton, Doug</creator><creator>Buckland, Aaron</creator><creator>Gerling, Michael</creator><creator>Soroceanu, Alex</creator><creator>Eastlack, Robert</creator><creator>Kojo Hamilton, D</creator><creator>Hart, Robert</creator><creator>Schwab, Frank</creator><creator>Lafage, Virginie</creator><creator>Shaffrey, Christopher</creator><creator>Sciubba, Daniel</creator><creator>Bess, Shay</creator><creator>Ames, Christopher</creator><creator>Klineberg, Eric</creator><general>International Society for the Advancement of Spine Surgery</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20220401</creationdate><title>Predictive Analytics for Determining Extended Operative Time in Corrective Adult Spinal Deformity Surgery</title><author>Passias, Peter G ; 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This study aims to determine factors associated with operative time using a statistical learning algorithm.
Retrospective review of a prospective multicenter database containing 837 patients undergoing long spinal fusions for ASD. Conditional inference decision trees identified factors associated with skin-to-skin operative time and cutoff points at which factors have a global effect. A conditional variable-importance table was constructed based on a nonreplacement sampling set of 2000 conditional inference trees. Means comparison for the top 15 variables at their respective significant cutoffs indicated effect sizes.
Included: 544 surgical ASD patients (mean age: 58.0 years; fusion length 11.3 levels; operative time: 378 minutes). The strongest predictor for operative time was institution/surgeon. Center/surgeons, grouped by decision tree hierarchy, a and b were, on average, 2 hours faster than center/surgeons c-f, who were 43 minutes faster than centers g-j, all
< 0.001. The next most important predictors were, in order, approach (combined vs posterior increases time by 139 minutes,
< 0.001), levels fused (<4 vs 5-9 increased time by 68 minutes,
< 0.050; 5-9 vs
10 increased time by 47 minutes,
< 0.001), age (age <50 years increases time by 57 minutes,
< 0.001), and patient frailty (score <1.54 increases time by 65 minutes,
< 0.001). Surgical techniques, such as three-column osteotomies (35 minutes), interbody device (45 minutes), and decompression (48 minutes), also increased operative time. Both minor and major complications correlated with
66 minutes of increased operative time. Increased operative time also correlated with increased hospital length of stay (LOS), increased estimated intraoperative blood loss (EBL), and inferior 2-year Oswestry Disability Index (ODI) scores.
Procedure location and specific surgeon are the most important factors determining operative time, accounting for operative time increases <2 hours. Surgical approach and number of levels fused were also associated with longer operative times, respectively. Extended operative time correlated with longer LOS, higher EBL, and inferior 2-y ODI outcomes.
We further identified the poor outcomes associated with extended operative time during surgical correction of ASD, and attributed the useful predictors of time spent in the operating room, including site, surgeon, surgical approach, and the number of levels fused.]]></abstract><cop>Netherlands</cop><pub>International Society for the Advancement of Spine Surgery</pub><pmid>35444038</pmid><doi>10.14444/8174</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
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| ispartof | International journal of spine surgery, 2022-04, Vol.16 (2), p.291-299 |
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| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_9930651 |
| source | PubMed Central; Alma/SFX Local Collection |
| subjects | Lumbar Spine |
| title | Predictive Analytics for Determining Extended Operative Time in Corrective Adult Spinal Deformity Surgery |
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