Cargando…

Adverse events in neurosurgery: a comprehensive single-center analysis of a prospectively compiled database

PURPOSE: To prospectively identify and quantify neurosurgical adverse events (AEs) in a tertiary care hospital. METHODS: From January 2021 to December 2021, all patients treated in our department received a peer-reviewed AE-evaluation form at discharge. An AE was defined as any event after surgery t...

Descripción completa

Detalles Bibliográficos
Autores principales: Dao Trong, Philip, Olivares, Arturo, El Damaty, Ahmed, Unterberg, Andreas
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Vienna 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10006024/
https://www.ncbi.nlm.nih.gov/pubmed/36624233
http://dx.doi.org/10.1007/s00701-022-05462-w
_version_ 1784905220942200832
author Dao Trong, Philip
Olivares, Arturo
El Damaty, Ahmed
Unterberg, Andreas
author_facet Dao Trong, Philip
Olivares, Arturo
El Damaty, Ahmed
Unterberg, Andreas
author_sort Dao Trong, Philip
collection PubMed
description PURPOSE: To prospectively identify and quantify neurosurgical adverse events (AEs) in a tertiary care hospital. METHODS: From January 2021 to December 2021, all patients treated in our department received a peer-reviewed AE-evaluation form at discharge. An AE was defined as any event after surgery that resulted in an undesirable clinical outcome, which is not caused by the underlying disease, that prolonged patient stay, resulted in readmission, caused a new neurological deficit, required revision surgery or life-saving intervention, or contributed to death. We considered AEs occurring within 30 days after discharge. AEs were categorized in wound event, cerebrospinal fluid (CSF) event, CSF shunt malfunction, post-operative infection, malpositioning of implanted material, new neurological deficit, rebleeding, and surgical goal not achieved and non-neurosurgical AEs. RESULTS: 2874 patients were included. Most procedures were cranial (45.1%), followed by spinal (33.9%), subdural (7.7%), CSF (7.0%), neuromodulation (4.0%), and other (2.3%). In total, there were 621 AEs shared by 532 patients (18.5%). 80 (2.8%) patients had multiple AEs. Most AEs were non-neurosurgical (222; 8.1%). There were 172 (6%) revision surgeries. Patients receiving cranial interventions had the most AEs (19.1%) although revision surgery was only necessary in 3.1% of patients. Subdural interventions had the highest revision rate (12.6%). The majority of fatalities was admitted as an emergency (81/91 patients, 89%). Ten elective patients had lethal complications, six of them related to surgery (0.2%). CONCLUSION: This study presents the one-year results of a prospectively compiled AE database. Neurosurgical AEs arose in one in five patients. Although the need for revision surgery was low, the rate of AEs highlights the importance of a systematic AE database to deliver continued high-quality in a high-volume center.
format Online
Article
Text
id pubmed-10006024
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher Springer Vienna
record_format MEDLINE/PubMed
spelling pubmed-100060242023-03-12 Adverse events in neurosurgery: a comprehensive single-center analysis of a prospectively compiled database Dao Trong, Philip Olivares, Arturo El Damaty, Ahmed Unterberg, Andreas Acta Neurochir (Wien) Original Article - Neurosurgery General PURPOSE: To prospectively identify and quantify neurosurgical adverse events (AEs) in a tertiary care hospital. METHODS: From January 2021 to December 2021, all patients treated in our department received a peer-reviewed AE-evaluation form at discharge. An AE was defined as any event after surgery that resulted in an undesirable clinical outcome, which is not caused by the underlying disease, that prolonged patient stay, resulted in readmission, caused a new neurological deficit, required revision surgery or life-saving intervention, or contributed to death. We considered AEs occurring within 30 days after discharge. AEs were categorized in wound event, cerebrospinal fluid (CSF) event, CSF shunt malfunction, post-operative infection, malpositioning of implanted material, new neurological deficit, rebleeding, and surgical goal not achieved and non-neurosurgical AEs. RESULTS: 2874 patients were included. Most procedures were cranial (45.1%), followed by spinal (33.9%), subdural (7.7%), CSF (7.0%), neuromodulation (4.0%), and other (2.3%). In total, there were 621 AEs shared by 532 patients (18.5%). 80 (2.8%) patients had multiple AEs. Most AEs were non-neurosurgical (222; 8.1%). There were 172 (6%) revision surgeries. Patients receiving cranial interventions had the most AEs (19.1%) although revision surgery was only necessary in 3.1% of patients. Subdural interventions had the highest revision rate (12.6%). The majority of fatalities was admitted as an emergency (81/91 patients, 89%). Ten elective patients had lethal complications, six of them related to surgery (0.2%). CONCLUSION: This study presents the one-year results of a prospectively compiled AE database. Neurosurgical AEs arose in one in five patients. Although the need for revision surgery was low, the rate of AEs highlights the importance of a systematic AE database to deliver continued high-quality in a high-volume center. Springer Vienna 2023-01-10 2023 /pmc/articles/PMC10006024/ /pubmed/36624233 http://dx.doi.org/10.1007/s00701-022-05462-w Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Original Article - Neurosurgery General
Dao Trong, Philip
Olivares, Arturo
El Damaty, Ahmed
Unterberg, Andreas
Adverse events in neurosurgery: a comprehensive single-center analysis of a prospectively compiled database
title Adverse events in neurosurgery: a comprehensive single-center analysis of a prospectively compiled database
title_full Adverse events in neurosurgery: a comprehensive single-center analysis of a prospectively compiled database
title_fullStr Adverse events in neurosurgery: a comprehensive single-center analysis of a prospectively compiled database
title_full_unstemmed Adverse events in neurosurgery: a comprehensive single-center analysis of a prospectively compiled database
title_short Adverse events in neurosurgery: a comprehensive single-center analysis of a prospectively compiled database
title_sort adverse events in neurosurgery: a comprehensive single-center analysis of a prospectively compiled database
topic Original Article - Neurosurgery General
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10006024/
https://www.ncbi.nlm.nih.gov/pubmed/36624233
http://dx.doi.org/10.1007/s00701-022-05462-w
work_keys_str_mv AT daotrongphilip adverseeventsinneurosurgeryacomprehensivesinglecenteranalysisofaprospectivelycompileddatabase
AT olivaresarturo adverseeventsinneurosurgeryacomprehensivesinglecenteranalysisofaprospectivelycompileddatabase
AT eldamatyahmed adverseeventsinneurosurgeryacomprehensivesinglecenteranalysisofaprospectivelycompileddatabase
AT unterbergandreas adverseeventsinneurosurgeryacomprehensivesinglecenteranalysisofaprospectivelycompileddatabase