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Risk factors of perioperative complications for posterior spinal fusion in degenerative scoliosis patients: a retrospective study

BACKGROUNDS: Rare study has been conducted to detect risk factors of perioperative complications, which are closely related to preoperative status of the patients and surgical stress. The aim of this study is to detect these relationships in degenerative scoliosis (DS) patients. METHODS: Perioperati...

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Autores principales: Wang, Hai, Zhang, Zheping, Qiu, Guixing, Zhang, Jianguo, Shen, Jianxiong
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6053713/
https://www.ncbi.nlm.nih.gov/pubmed/30025521
http://dx.doi.org/10.1186/s12891-018-2148-x
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author Wang, Hai
Zhang, Zheping
Qiu, Guixing
Zhang, Jianguo
Shen, Jianxiong
author_facet Wang, Hai
Zhang, Zheping
Qiu, Guixing
Zhang, Jianguo
Shen, Jianxiong
author_sort Wang, Hai
collection PubMed
description BACKGROUNDS: Rare study has been conducted to detect risk factors of perioperative complications, which are closely related to preoperative status of the patients and surgical stress. The aim of this study is to detect these relationships in degenerative scoliosis (DS) patients. METHODS: Perioperative complications of 226 cases with DS (56 males and 170 females; 65.5 ± 8.1 years old), who accepted posterior fusion in our hospital from January, 2013 to July, 2017, were retrospectively reviewed. Potential risk factors were first compared between patients with or without perioperative complications using student t test or Chi-squared test. Then, the unevenly distributed variables between the two groups were analyzed with binary logistic regression model. RESULTS: All patients separately underwent decompression with short limited instrumentation (116, 51.3%) or with long instrumentation for correction (110, 48.7%). The mean operation duration (OD) was 216.9 ± 64.2 min and the average amount of bleeding was 587.4 ± 357.2 ml. 44 cases (19.5%)suffered from the complications during the perioperative phase, including incision complications (5.3%), urinary infection (3.5%), dura tears/cerebrospinal fluid (CSF) leakages (3.5%) and new neurological deficits (2.7%). Hospital stay was significantly extended for the complications (p < 0.001). Univariate analysis showed that OD (p < 0.001), bleeding (p = 0.014), American Standards Association (ASA) grade > 2 (p = 0.011) and RBC transfusion≥4 U(p = 0.028) were associated with these complications. Multivariate logistic regressions revealed that only ASA grade > 2(p = 0.011, Odds Ratio[OR] = 4.104, 95% Confidence Interval[CI] = 1.413~ 11.917) and OD (p = 0.013, OR = 2.697, 95% CI = 1.233~ 5.899) were the independent risk factors. CONCLUSIONS: The high morbidity of perioperative complications for posterior spinal fusion would significantly extend hospital stay of DS patients. It was independently related to higher ASA grade and longer OD.
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spelling pubmed-60537132018-07-23 Risk factors of perioperative complications for posterior spinal fusion in degenerative scoliosis patients: a retrospective study Wang, Hai Zhang, Zheping Qiu, Guixing Zhang, Jianguo Shen, Jianxiong BMC Musculoskelet Disord Research Article BACKGROUNDS: Rare study has been conducted to detect risk factors of perioperative complications, which are closely related to preoperative status of the patients and surgical stress. The aim of this study is to detect these relationships in degenerative scoliosis (DS) patients. METHODS: Perioperative complications of 226 cases with DS (56 males and 170 females; 65.5 ± 8.1 years old), who accepted posterior fusion in our hospital from January, 2013 to July, 2017, were retrospectively reviewed. Potential risk factors were first compared between patients with or without perioperative complications using student t test or Chi-squared test. Then, the unevenly distributed variables between the two groups were analyzed with binary logistic regression model. RESULTS: All patients separately underwent decompression with short limited instrumentation (116, 51.3%) or with long instrumentation for correction (110, 48.7%). The mean operation duration (OD) was 216.9 ± 64.2 min and the average amount of bleeding was 587.4 ± 357.2 ml. 44 cases (19.5%)suffered from the complications during the perioperative phase, including incision complications (5.3%), urinary infection (3.5%), dura tears/cerebrospinal fluid (CSF) leakages (3.5%) and new neurological deficits (2.7%). Hospital stay was significantly extended for the complications (p < 0.001). Univariate analysis showed that OD (p < 0.001), bleeding (p = 0.014), American Standards Association (ASA) grade > 2 (p = 0.011) and RBC transfusion≥4 U(p = 0.028) were associated with these complications. Multivariate logistic regressions revealed that only ASA grade > 2(p = 0.011, Odds Ratio[OR] = 4.104, 95% Confidence Interval[CI] = 1.413~ 11.917) and OD (p = 0.013, OR = 2.697, 95% CI = 1.233~ 5.899) were the independent risk factors. CONCLUSIONS: The high morbidity of perioperative complications for posterior spinal fusion would significantly extend hospital stay of DS patients. It was independently related to higher ASA grade and longer OD. BioMed Central 2018-07-19 /pmc/articles/PMC6053713/ /pubmed/30025521 http://dx.doi.org/10.1186/s12891-018-2148-x Text en © The Author(s). 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Wang, Hai
Zhang, Zheping
Qiu, Guixing
Zhang, Jianguo
Shen, Jianxiong
Risk factors of perioperative complications for posterior spinal fusion in degenerative scoliosis patients: a retrospective study
title Risk factors of perioperative complications for posterior spinal fusion in degenerative scoliosis patients: a retrospective study
title_full Risk factors of perioperative complications for posterior spinal fusion in degenerative scoliosis patients: a retrospective study
title_fullStr Risk factors of perioperative complications for posterior spinal fusion in degenerative scoliosis patients: a retrospective study
title_full_unstemmed Risk factors of perioperative complications for posterior spinal fusion in degenerative scoliosis patients: a retrospective study
title_short Risk factors of perioperative complications for posterior spinal fusion in degenerative scoliosis patients: a retrospective study
title_sort risk factors of perioperative complications for posterior spinal fusion in degenerative scoliosis patients: a retrospective study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6053713/
https://www.ncbi.nlm.nih.gov/pubmed/30025521
http://dx.doi.org/10.1186/s12891-018-2148-x
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