H Zhao1, C F Hu, Y Hai. 1. Department of Orthopedics, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China.
Abstract
OBJECTIVE: To analyze risk factors of major complications after spinal deformity surgery. METHODS: From January 2011 to December 2014, 254 consecutive patients undergone spinal deformity surgery , 68 male and 186 female, average age 22.1(3-73) years, were divided into two groups based on if they had major complications after surgery.Univariate and multivariate analysis (Logistic regression) were used to identify the risk factors. RESULTS: Among them, 29 patients had major complications after surgery.Univariate risk factors showed that medical history, scoliosis operation history, preoperative nerve injury, vertebral number of major curve, cobb of major curve, Kyphosis(>90°), time of operation, operative bleeding and osteotomy of group Ⅰ were higher or longer than those of group Ⅱ.Maximal voluntary ventilation (MVC) and orthopaedic rate of group Ⅰ were worse than those of group Ⅱ[(63.5%±23.9%)vs(76.7%±21.9%), (53%±23%) vs(68%±21%), P<0.05]. Logistic regression identified that preoperative nerve injury(OR=5.976), medical history>10 years (OR=4.095), MVC observed/predicted<50(OR=7.405), time of operation>5 h (OR=3.510), osteotomy(OR=3.472)were final risk factors for major complications. CONCLUSIONS: Major complications after surgery to treat spinal deformity can be predicted through preoperative nerve injury, medical history, maximal voluntary ventilation observed/predicted, time of operation and osteotomy during the surgery.The patients with these risk factors need more preoperative care and postoperative care to reduce the occurrence of major complications.
OBJECTIVE: To analyze risk factors of major complications after spinal deformity surgery. METHODS: From January 2011 to December 2014, 254 consecutive patients undergone spinal deformity surgery , 68 male and 186 female, average age 22.1(3-73) years, were divided into two groups based on if they had major complications after surgery.Univariate and multivariate analysis (Logistic regression) were used to identify the risk factors. RESULTS: Among them, 29 patients had major complications after surgery.Univariate risk factors showed that medical history, scoliosis operation history, preoperative nerve injury, vertebral number of major curve, cobb of major curve, Kyphosis(>90°), time of operation, operative bleeding and osteotomy of group Ⅰ were higher or longer than those of group Ⅱ.Maximal voluntary ventilation (MVC) and orthopaedic rate of group Ⅰ were worse than those of group Ⅱ[(63.5%±23.9%)vs(76.7%±21.9%), (53%±23%) vs(68%±21%), P<0.05]. Logistic regression identified that preoperative nerve injury(OR=5.976), medical history>10 years (OR=4.095), MVC observed/predicted<50(OR=7.405), time of operation>5 h (OR=3.510), osteotomy(OR=3.472)were final risk factors for major complications. CONCLUSIONS: Major complications after surgery to treat spinal deformity can be predicted through preoperative nerve injury, medical history, maximal voluntary ventilation observed/predicted, time of operation and osteotomy during the surgery.The patients with these risk factors need more preoperative care and postoperative care to reduce the occurrence of major complications.