Impact of resolved early major complications on 2-year follow-up outcome following adult spinal deformity surgery.

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Abstrakt

Tytuł:: Impact of resolved early major complications on 2-year follow-up outcome following adult spinal deformity surgery.
Autorzy:: Núñez-Pereira S; Spine Research Unit, Vall D'Hebron Research Institute, Barcelona, Spain. .; Department of Orhtopaedics and Traumatology, Hospital Universitario Donostia, Servicio de Cirugía Ortopédica Y Traumatología, Paseo del Dr Begiristain 110, 20014, Donostia/San Sebastián, Spain. .
Pellisé F; Spine Research Unit, Vall D'Hebron Research Institute, Barcelona, Spain.; Spine Surgery Unit, Vall d'Hebron University Hospital, Barcelona, Spain.
Vila-Casademunt A; Spine Research Unit, Vall D'Hebron Research Institute, Barcelona, Spain.
Alanay A; Department of Orthopaedics and Traumatology, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey.
Acaraglou E; Ankara ARTES Spine Center, Ankara, Turkey.
Obeid I; Spine Surgery Unit, Bordeaux University Hospital, Bordeaux, France.
Sánchez Pérez-Grueso FJ; Spine Surgery Unit, Hospital La Paz, Madrid, Spain.
Kleinstück F; Spine Center Division, Schulthess Klinik, Zurich, Switzerland.
Corporate Authors:: ESSG European Spine Study Group
Źródło:: European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society [Eur Spine J] 2019 Sep; Vol. 28 (9), pp. 2208-2215. Date of Electronic Publication: 2019 Jun 27.
Typ publikacji:: Journal Article; Research Support, Non-U.S. Gov't
Język:: English
Imprint Name(s):: Original Publication: Heidelberg, Federal Republic of Germany : Springer-Verlag, c1992-
MeSH Terms:: Postoperative Complications/*epidemiology
Spinal Curvatures/*surgery
Spinal Fusion/*adverse effects
Adult ; Aged ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Quality of Life ; Retrospective Studies ; Treatment Outcome
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Contributed Indexing:: Keywords: Adult spinal deformity; Complications; Outcome
Entry Date(s):: Date Created: 20190629 Date Completed: 20200817 Latest Revision: 20200817
Update Code:: 20240104
DOI:: 10.1007/s00586-019-06041-x
PMID:: 31250173
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Purpose: Major complications are a concern following ASD surgery. Even when properly managed and resolved, they may still have a relevant impact on HRQL. We aimed to investigate the impact of resolved early major complications on 2-year outcome after ASD surgery.
Methods: Two groups of consecutive surgical patients were extracted from a prospective multicentre database. Major complication group (MCG) included patients with any major complication, resolved within 6 months after surgery. Patients with further major complications during follow-up were excluded. Control group (CG) included patients with no major complications over the entire follow-up. Analysis of covariance adjusting for preoperative baseline values was used to compare improvements in HRQL measures at 2 years.
Results: One hundred and seventy-five patients met the inclusion criteria and had complete HRQL data at 2 years (24 MCG, 151 CG). MCG patients were older and had more severe deformity and poorer baseline HRQL. There were 27 resolved major complications at 6 months needing 19 additional surgeries (18 revisions, 1 cholecystectomy). At 2 years, and after adjusting for preoperative data, outcome in MCG patients was as follows: scores were 5.98 (SE 3.03) points higher for the ODI (p = 0.05), 0.36 (SE 0.13) lower SRS-22 function (p = 0.01), 4.07 (SE 1.93) lower SF-36 PCS (p = 0.04), and 0.16 (SE 0.13) lower SRS-22 subtotal (p = 0.22).
Conclusion: The results indicate that patients experiencing major complications after ASD surgery have significantly less functional improvement (SRS-22 function, ODI, SF-36 PCS) than their complication-free counterparts, even when complications were considered resolved, and the outcome was measured after an 18-month complication-free period. These slides can be retrieved under Electronic Supplementary Material.

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