Adverse events and their risk factors 90 days after cervical spine surgery: analysis from the Michigan Spine Surgery Improvement Collaborative

Zakaria, Hesham Mostafa; Bazydlo, Michael; Schultz, Lonni; Pahuta, Markian; Schwalb, Jason M.; Park, Paul; Aleem, Ilyas; Nerenz, David R.; Chang, Victor

doi:10.3171/2018.10.spine18666

Cited by 12 publications

(16 citation statements)

References 42 publications

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“…Zakaria et al also examined 8236 patients who had undergone cervical spinal surgery and estimated the POUR incidence to be 4.7%. 11 An analysis of the risk factors found that the male sex ( p < 0.001), old age ( p = 0.019), depression, ambulatory preop, and anterior surgical approach were all strongly associated with POUR for cervical spinal surgery.…”

Section: Resultsmentioning

confidence: 98%

“…The lack of extensive research examining cervical, thoracic, and lumbar surgeries separately poses a significant challenge for assessing the POUR incidence and risk factors unique to spinal surgeries performed at different regions. Radcliff et al and Zakaria et al were the only two studies that focused on cervical spinal surgeries; 10,11 no study focused only on thoracic spinal surgery. Future studies should investigate cervical, thoracic, and lumbar regions with respect to the type of spinal injury and surgery performed to determine whether different spinal injuries or surgical approaches increase or decrease the risk of POUR.…”

Section: Discussionmentioning

confidence: 99%

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Spinal surgery and urinary retention: A review of the literature

Kopel

2020

Journal of Clinical Urology

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Objective: Postoperative urinary retention is a common complication for patients recovering from general anesthesia or invasive surgery near the spinal column. However, no study has systematically reviewed the incidence of postoperative urinary retention for spinal surgeries performed at the cervical, thoracic, or lumbar spinal regions. In this review, we critically analyze and summarize the known literature on the incidence and risk factors associated with postoperative urinary retention after spinal surgery. Methods: A comprehensive literature review was performed at the end of September 2019 within the PubMed database. Results: The average incidence of postoperative urinary retention from nine of the 10 studies was 17.2% with one paper that did not report on postoperative urinary retention incidence. Furthermore, age, male gender, location and history of spinal surgery, duration of surgery, benign prostatic hypertrophy, and Foley catheter were reported as major risk factors for postoperative urinary retention and spinal surgery. Conclusion: Overall, spinal cord and postoperative urinary retention remains a poorly understood area requiring further investigation into the incidence, risk factors, and surgical methods influence postoperative urinary retention and post-operative outcomes. We believe an overview of such data can help revise guidelines for the management of postoperative urinary retention and raise awareness of its prevalence in elderly patients undergoing spinal surgery. Level of evidence: Not applicable for this multicentre audit.

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Section: Resultsmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Spinal surgery and urinary retention: A review of the literature

Kopel

2020

Journal of Clinical Urology

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“…MSSIC is designed to focus on routine degenerative conditions and common spine surgeries to allow for the greatest comparability and quality improvement. 17 Criteria for inclusion in MSSIC include cervical and/or lumbar spine surgery for general degenerative conditions, such as spondylosis, intervertebral disc disease, and low grade (grade 1 or 2) spondylolisthesis. Exclusion criteria include complex diagnoses, such as patients less than 18 years old, moderate (258-508) or severe (>508) scoliosis, tumor, infection, spinal deformity, traumatic fracture, and spinal cord injury.…”

Section: Methods Design Setting and Participantsmentioning

confidence: 99%

Age as a Risk Factor for Complications Following Anterior Cervical Discectomy and Fusion

Lawless

Tong

Claus

et al. 2021

Spine

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Study Design. Retrospective analysis of prospectively collected registry data using multivariable analyses of imputed data Objective. We sought to demonstrate that age would not be associated with complications in patients undergoing anterior cervical discectomy and fusion (ACDF). Summary of Background Data. Elderly patients (!70 yrs) undergoing ACDF are considered a higher risk for complications. However, conclusive evidence is lacking. The Michigan Spine Surgery Improvement Collaborative (MSSIC) is a quality improvement collaborative with 30 hospitals across Michigan. Methods. The study included all patients who had 1 to 4 level ACDF (September 2015-August 2019) for 90-day complications. Major and minor complications were defined using a validated classification. Multiple imputations were used to generate complete covariate datasets. Generalized estimating equation model was used to identify associations with complications using the whole cohort and elderly subgroup analyses. Bonferroni correction was used.Results. Nine thousand one hundred thirty five patients (11.1% ! 70 yrs and 88.9% <70 yrs) with 2266 complications were analyzed. Comparing elderly versus non-elderly, the elderly had a significantly higher rate of any complications (31.5% vs. 24.0%, P < 0.001) and major complications (14.1% vs. 7.0%, P < 0.001). On multivariable analysis, age was not independently associated with any complication. POD#0 ambulation and preop independent ambulation were independently associated with significantly decreased odds of any complication. In the elderly, independent preoperative ambulation was protective for any complication (odds ratio [OR] 0.53, 0.39-0.73 95% confidence interval [CI]), especially major complications (OR 0.41, 0.27-0.61 95% CI). Conclusion. Age was not an independent risk factor for complications in patients that underwent ACDF. In the elderly, independent preoperative ambulation was especially protective for major complications.

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“…Once unplanned readmission occurs, it will bring heavy mental burden and economic pressure to the patients and at the same time increase the difficulty of diagnosis and treatment for physicians. Ninety-day readmission is the rehospitalization of a patient who underwent cervical surgery within 90 days of discharge due to unpredictable factors such as the same disease or complications [ 10 , 11 ]. According to literature analysis, the readmission rate within 90 days after cervical surgery is 5–13% [ 9 , 12 ].…”

Section: Introductionmentioning

confidence: 99%

Risk factors for ninety-day readmission following cervical surgery: a meta-analysis

Wang

Liao

et al. 2022

J Orthop Surg Res

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Background As an important evaluation index after cervical surgery, ninety-day readmission is gradually being valued. Our study collected the latest published relevant studies, analyzed the risk factors of ninety-day readmission after cervical surgery, and continuously improved the postoperative rehabilitation plan. This study focuses on two research hotspots: (1) What is the rate of ninety-day readmission after cervical surgery? (2) What are the risk factors affecting the ninety-day readmission? Methods Based on the Cochrane Library, PubMed, Web of Science, and Embase databases, this study searched for studies about ninety-day readmission after cervical surgery, from the establishment of the database to August 1, 2022. The evaluation indicators are as follows: age, American Society of Anesthesiology physical status (ASA) class, diabetes, hypertension, chronic heart diseases, chronic lung diseases, income, and payments for hospitalization. The meta-analysis was performed using Review Manager 5.4. Results Seven studies with 222,490 participants were eligible for our meta-analysis. The analysis displayed that there were statistically significant differences in the age (MD = − 4.60, 95%CI − 4.89–4.31, p < 0.001), diabetes (OR = 0.60, 95%CI 0.56–0.64, p < 0.00001), hypertension (OR = 0.40, 95%CI 0.30–0.54, p < 0.00001), chronic heart diseases (OR = 0.05, 95%CI 0.01–0.19, p < 0.00001), chronic lung diseases (OR = 0.46, 95%CI 0.43–0.49, p < 0.00001), income (OR = 2.85, 95%CI 1.82–4.46, p < 0.00001), and payments for hospitalization (OR = 2.29, 95%CI 1.14–4.59, p = 0.02) between readmission and no readmission groups. In terms of the ASA, there was no difference on the ninety-day readmission (p = 0.78). Conclusion Age, diabetes, hypertension, chronic heart diseases, chronic lung diseases, income, and payments for hospitalization are the risk factors of ninety‐day readmission following cervical surgery.

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Adverse events and their risk factors 90 days after cervical spine surgery: analysis from the Michigan Spine Surgery Improvement Collaborative

Cited by 12 publications

References 42 publications

Spinal surgery and urinary retention: A review of the literature

Spinal surgery and urinary retention: A review of the literature

Age as a Risk Factor for Complications Following Anterior Cervical Discectomy and Fusion

Risk factors for ninety-day readmission following cervical surgery: a meta-analysis

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