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Differences in Perioperative Management of Patients Undergoing Complex Spine Surgery: A Global Perspective.

Authors :
Blacker SN
Woody N
Abate Shiferaw A
Burbridge M
Bustillo MA
Hazard SW
Heller BJ
Lamperti M
Mejia-Mantilla J
Nadler JW
Rath GP
Robba C
Vincent A
Admasu AK
Awraris M
Lele AV
Source :
Journal of neurosurgical anesthesiology [J Neurosurg Anesthesiol] 2024 Jul 01; Vol. 36 (3), pp. 218-227. Date of Electronic Publication: 2023 May 16.
Publication Year :
2024

Abstract

Background: The aim of this survey was to understand institutional spine surgery practices and their concordance with published best practices/recommendations.<br />Methods: Using a global internet-based survey examining perioperative spine surgery practice, reported institutional spine pathway elements (n=139) were compared with the level of evidence published in guideline recommendations. The concordance of clinical practice with guidelines was categorized as poor (≤20%), fair (21%-40%), moderate (41%-60%), good (61%-80%), or very good (81%-100%).<br />Results: Seventy-two of 409 (17.6%) institutional contacts started the survey, of which 31 (7.6%) completed the survey. Six (19.4%) of the completed surveys were from respondents in low/middle-income countries, and 25 (80.6%) were from respondents in high-income countries. Forty-one incomplete surveys were not included in the final analysis, as most were less than 40% complete. Five of 139 (3.6%) reported elements had very good concordance for the entire cohort; hospitals with spine surgery pathways reported 18 elements with very good concordance, whereas institutions without spine surgery pathways reported only 1 element with very good concordance. Reported spine pathways included between 7 and 47 separate pathway elements. There were 87 unique elements in the reviewed pathways. Only 3 of 87 (3.4%) elements with high-quality evidence demonstrated very good practice concordance.<br />Conclusions: This global survey-based study identified practice variation and low adoption rates of high-quality evidence in the care of patients undergoing complex spine surgery.<br />Competing Interests: A.V.L. reports receiving salary support from LifeCenter Northwest. C.R. is a member of the Editorial Board of the Journal of Neurosurgical Anesthesiology. The remaining authors have no conflicts of interest to declare.<br /> (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)

Details

Language :
English
ISSN :
1537-1921
Volume :
36
Issue :
3
Database :
MEDLINE
Journal :
Journal of neurosurgical anesthesiology
Publication Type :
Academic Journal
Accession number :
37192477
Full Text :
https://doi.org/10.1097/ANA.0000000000000919