Gaston Camino-Willhuber1,2, Alfredo Guiroy2,3, Mariano Servidio4, Nelson Astur2,5,6, Fernando Nin-Vilaró7, Fernando Alvarado-Gomez8, Murilo Daher9, Bruno Saciloto10, Allan Ono11, Olavo Letaif12, Baron Zarate-Kalfopulos2,13, Ratko Yurac2,14,15, Emiliano Vialle2,16, Marcelo Valacco2,4. 1. Institute of Orthopedics "Carlos E. Ottolenghi," Hospital Italiano de Buenos Aires, Buenos Aires, Argentina. 2. AOSpine Latin America Study Group, Curitiba, Brazil. 3. Spine Unit, Orthopedic Department, Hospital Español de Mendoza, Mendoza, Argentina. 4. Hospital Churruca Visca, Buenos Aires, Argentina. 5. Santa Casa de Misericordia de San Pablo, São Paulo, Brazil. 6. Hospital Israelita Albert Einstein, Morumbi, São Paulo, Brazil. 7. Médica Uruguaya, Montevideo, Uruguay. 8. Department of Orthopedic Surgery, Fundación Santa Fe de Bogotá, Bogotá, Colombia. 9. Departamento de Ortopedia e Traumatologia, Faculdade de Medicina, Universidade Federal de Goiás, Goiânia, GO, Brasil. 10. Clínica Bambina Pontifícia Universidade Católica do Paraná, Brasil. 11. Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (IOT-HCFMUSP), Instituto de Ortopedia e Traumatología, Spine Surgery Division, São Paulo, SP, Brazil. 12. Department of Orthopedics and Traumatology, IOT HCFMUSP, São Paulo, Brazil. 13. Instituto Nacional de Rehabilitación, Distrito Federal, Mexico. 14. Department of Orthopedic and Traumatology, University del Desarrollo, Santiago, Chile. 15. Spine Unit, Department of Traumatology, Clínica Alemana, Santiago, Chile. 16. Cajuru Hospital, Catholic University of Parana, Caritiba, Brazil.
Abstract
STUDY DESIGN: Multicentric retrospective study, Level of evidence III. OBJECTIVE: The objective of this multicentric study was to analyze the prevalence and risk factors of early postoperative complications in adult spinal deformity patients treated with fusion. Additionally, we studied the impact of complications on unplanned readmission and hospital length of stay. METHODS: Eight spine centers from 6 countries in Latin America were involved in this study. Patients with adult spinal deformity treated with fusion surgery from 2017 to 2019 were included. Baseline and surgical characteristics such as age, sex, comorbidities, smoking, number of levels fused, number of surgical approaches were analyzed. Postoperative complications at 30 days were recorded according to Clavien-Dindo and Glassman classifications. RESULTS: 172 patients (120 females/52 males, mean age 59.4 ± 17.6) were included in our study. 78 patients suffered complications (45%) at 30 days, 43% of these complications were considered major. Unplanned readmission was observed in 35 patients (20,3%). Risk factors for complications were: Smoking, previous comorbidities, number of levels fused, two or more surgical approaches and excessive bleeding. Hospital length of stay in patients without and with complications was of 7.8 ± 13.7 and 17 ± 31.1 days, respectively (P 0.0001). CONCLUSION: The prevalence of early postoperative complications in adult spinal deformity patients treated with fusion was of 45% in our study with 20% of unplanned readmissions at 30 days. Presence of complications significantly increased hospital length of stay.
STUDY DESIGN: Multicentric retrospective study, Level of evidence III. OBJECTIVE: The objective of this multicentric study was to analyze the prevalence and risk factors of early postoperative complications in adult spinal deformity patients treated with fusion. Additionally, we studied the impact of complications on unplanned readmission and hospital length of stay. METHODS: Eight spine centers from 6 countries in Latin America were involved in this study. Patients with adult spinal deformity treated with fusion surgery from 2017 to 2019 were included. Baseline and surgical characteristics such as age, sex, comorbidities, smoking, number of levels fused, number of surgical approaches were analyzed. Postoperative complications at 30 days were recorded according to Clavien-Dindo and Glassman classifications. RESULTS: 172 patients (120 females/52 males, mean age 59.4 ± 17.6) were included in our study. 78 patients suffered complications (45%) at 30 days, 43% of these complications were considered major. Unplanned readmission was observed in 35 patients (20,3%). Risk factors for complications were: Smoking, previous comorbidities, number of levels fused, two or more surgical approaches and excessive bleeding. Hospital length of stay in patients without and with complications was of 7.8 ± 13.7 and 17 ± 31.1 days, respectively (P 0.0001). CONCLUSION: The prevalence of early postoperative complications in adult spinal deformity patients treated with fusion was of 45% in our study with 20% of unplanned readmissions at 30 days. Presence of complications significantly increased hospital length of stay.
Authors: Gaston Camino-Willhuber; Sarah Oyadomari; Jonathan Ochoa; Fernando Holc; Alfredo Guiroy; Hansen Bow; Sohaib Hashmi; Michael Oh; Nitin Bhatia; Yu-Po Lee Journal: Surg Neurol Int Date: 2022-08-12