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The impact of perioperative complications on clinical outcome in adult deformity surgery.
- Source :
-
Spine (03622436) . Nov2007, Vol. 32 Issue 24, p2764-2770. 7p. - Publication Year :
- 2007
-
Abstract
- STUDY DESIGN: Retrospective case-control series. OBJECTIVE: The purpose of this study is to determine whether perioperative complications alter subsequent clinical outcome measures in adult spinal deformity surgery. SUMMARY OF BACKGROUND DATA: Increasingly, the benefit of surgical intervention is being evaluated based on patient reported outcomes and standardized health related quality of life (HRQOL) measures. As improvement or deterioration in HRQOL scores becomes a standard for clinical evaluation in adult spinal deformity, the correlation between HRQOL outcome scores and historic benchmarks, such as curve correction, sagittal balance, fusion healing, or the occurrence of a complication, must be clarified. METHODS: This study analyzes a prospective multicenter data base for adult spinal deformity. Patients with major, minor, and no complications were matched using a logistic regression technique producing 46 patients in each group. Standardized outcome measures at baseline and at 1 year postop were compared. RESULTS: Forty-seven major complications were reported in 46 patients. Sixty-two minor complications were noted in 46 patients. Comparison between the 3 complication groups revealed that 1-year postoperative outcome measures were not statistically different for the Scoliosis Research Society Outcomes Instrument, Medical Outcomes Short Form-36 (SF-12), Oswestry Disability Index, or Numerical Pain Scales. The only significant interaction was in the rate of change from preop to 1-year postop for the SF-12 general health subscale. For the group with major complications, SF-12 general health deteriorated by 2.1 points from preop to 1-year postop. During the same period, the group with minor complications experienced an improvement of 4.2 points and the group with no complications experienced an improvement of 1.5 points. CONCLUSION: This study suggests that risk for minor complications may be a less substantial obstacle than previously assumed for surgical treatment in adult spinal deformity. In contrast, major complications were reported in approximately 10% of cases and adversely affected outcome as evidenced by the deterioration in SF-12 general health scores at 1 year after surgery. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 03622436
- Volume :
- 32
- Issue :
- 24
- Database :
- Academic Search Index
- Journal :
- Spine (03622436)
- Publication Type :
- Academic Journal
- Accession number :
- 105831361
- Full Text :
- https://doi.org/10.1097/brs.0b013e31815a7644