Lumbar Discectomy Outcomes by Specialty: A Propensity-Matched Analysis of 7464 Patients from the ACS-NSQIP Database

Esfahani, Darian R.; Shah, Harsh; Arnone, Gregory D.; Mehta, Ankit I.

doi:10.1016/j.wneu.2018.07.077

Cited by 12 publications

(27 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…There was a statistically significant higher rate of urinary tract infection (UTI) (1.2 vs 0.3%) and blood transfusions (0.75 vs 0.12%) in the matched inpatient cohort compared to the outpatient. Although the mortality rate of discectomy is vanishingly rare, there was a 0.04% inpatient and 0.06% outpatient mortality rate in the Pugely study within 30 days of discectomy [7] and 0.1% mortality rate among the neurosurgery cohort in the Esfahani study [6].…”

Section: Medical Complicationsmentioning

confidence: 95%

“…Surgical training, and therefore the surgical specialty, may affect the rate of complications in discectomy. Esfahani et al sampled the NSQIP database to analyze whether surgical specialty had any impact on lumbar discectomy complications [6]. They found that orthopaedic surgeons and neurosurgeons were similar in all post-operative outcomes and complications, except for higher rate of blood transfusions for orthopaedic surgeons (0.3 vs 0.1%) and longer operative times for neurosurgeons (83.7 vs 72.5 min).…”

Section: Factors Affecting Complicationsmentioning

confidence: 99%

“…Although patients tend to be relatively healthy, there does exists a risk for pulmonary embolism (PE), deep vein thrombosis (DVT), pneumonia, UTI, myocardial infarction (MI), and other medical complications in this operative cohort. Esfahani et al demonstrated a low incidence of medical complications for neurosurgeons and orthopaedic surgeons with rates of 0.3% UTI 0.2% PE, 0.2% DVT, and 0.2% and 0.1% pneumonia, respectively, for 30-day complication rates between specialties of 7464 patients who underwent lumbar discectomy [6]. Pugely et al found similarly low incidence of medical complications in their comparative study of 30 day complications of discectomy in the inpatient and outpatient setting of 4310 patients taken from the NSQIP database.…”

Section: Medical Complicationsmentioning

confidence: 99%

See 2 more Smart Citations

The evidence-based approach for surgical complications in the treatment of lumbar disc herniation

Harper

Klineberg

2018

International Orthopaedics (SICOT)

View full text Add to dashboard Cite

Purpose The purpose of this article is to review the evidence-based approach for surgical complications following disc herniation. Methods A search of the primary English literature was conducted for research examining the outcomes and complications of surgical discectomy. Special regard was given to high-quality prospective randomized studies. ResultsThe most commonly reported complications of surgical treatment of disc herniation are included in this review. Medical complications, and surgical complications including infection, durotomy, neurological injury, symptomatic re-herniation, and revision surgery are defined and systematically reviewed in detail for incidence, evaluation, and management. Conclusion This article provides the clinician and surgeon with a review of the evidence-based evaluation and management of surgical complications following disc herniation, offering best practice guidelines for informed discussions with patients in shared decision-making.

show abstract

Section: Medical Complicationsmentioning

confidence: 95%

Section: Factors Affecting Complicationsmentioning

confidence: 99%

Section: Medical Complicationsmentioning

confidence: 99%

See 1 more Smart Citation

The evidence-based approach for surgical complications in the treatment of lumbar disc herniation

Harper

Klineberg

2018

International Orthopaedics (SICOT)

View full text Add to dashboard Cite

show abstract

“…Approximately 700 North American hospitals prospectively provide information regarding numerous clinical variables to this database, with these data periodically being audited in order to ensure its integrity and accuracy. Several studies in both orthopedic surgery and other surgical specialties have previously used NSQIP for their analyses [3,16,17]. Importantly, information regarding whether a resident was present in the room was only available during the 2008-2012 time period, and whether or not a procedure was elective was first recorded starting in 2011.…”

Section: Nsqip Databasementioning

confidence: 99%

What Factors Influence Operative Time in Total Knee Arthroplasty? A 10-Year Analysis in a National Sample

Acuña

Samuel

Karnuta

et al. 2020

The Journal of Arthroplasty

View full text Add to dashboard Cite

“…The ACS-NSQIP is an international database featuring more than 600 institutions used to record an array of standard surgical outcomes with the goal of improving the quality of surgical practice, 12 and it has been used in multiple neurosurgical studies examining surgical outcomes. [13][14][15][16][17][18][19][20] Data in the NSQIP database are acquired directly from patient charts rather than through billing records by specialized data collectors at each institution and subject to regular quality control reviews to ensure site-to-site uniformity. The period of data collection begins before surgery and extends until 30 days after the Fig.…”

Section: Data Acquisition and Patient Selectionmentioning

confidence: 99%

Supratentorial and Infratentorial Approaches to Pineal Surgery: A Database Analysis

et al. 2018

Self Cite

View full text Add to dashboard Cite

Objectives Neoplasms involving the pineal gland are rare. When they do occur, tumor resection is anatomically challenging and is traditionally addressed by either a supratentorial or an infratentorial approach. To date, no large, multicenter studies have been performed that systematically analyze outcomes comparing these two approaches. This study aimed to evaluate outcomes for patients undergoing pineal neoplasm resection, comparing supratentorial and infratentorial approaches. Design Retrospective database review. Setting Multi-institutional database. Participants From 2005 to 2016, 60 patients were identified, with 13 undergoing a supratentorial approach and 47 undergoing an infratentorial approach. Main Outcome Measures Patient demographics, comorbidities, and 30-day postoperative outcomes were investigated using the American College of Surgeons National Surgical Quality Improvement Program database. Demographics, readmission, reoperation, and complication rates were analyzed and compared with previous studies. Results Patient demographics were similar between these two groups. The overall complication rates for the supratentorial and infratentorial approaches were 30.8 and 17%, respectively, and the difference was not statistically significant. The most common medical complications encountered were respiratory and hematological. Conclusion As the first multi-institutional database analysis of approaches to the pineal gland, this study provides an analysis of patient demographics, comorbidities, and postoperative complications. After controlling for preoperative risk factors and demographic characteristics, no statistically significant differences in postoperative outcomes were found between infratentorial and supratentorial approaches. The mean readmission, reoperation, and complication rates were found to be 2.1, 8.3, and 20%, respectively. The lack of significant difference between approaches suggests that clinical decision-making should depend upon anatomical considerations and physician preference, although the complications illustrated here may provide some preoperative guidance.

show abstract

Lumbar Discectomy Outcomes by Specialty: A Propensity-Matched Analysis of 7464 Patients from the ACS-NSQIP Database

Cited by 12 publications

References 22 publications

The evidence-based approach for surgical complications in the treatment of lumbar disc herniation

The evidence-based approach for surgical complications in the treatment of lumbar disc herniation

What Factors Influence Operative Time in Total Knee Arthroplasty? A 10-Year Analysis in a National Sample

Supratentorial and Infratentorial Approaches to Pineal Surgery: A Database Analysis

Contact Info

Product

Resources

About