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Complication rates following Chiari malformation surgical management for Arnold–Chiari type I based on surgical variables: A national perspective
INTRODUCTION: This study aimed to identify complication trends of Chiari Malformation Type 1 patients (CM-1) for certain procedures and concomitant diagnoses on a national level. MATERIALS: The Kids’ Inpatient Database was queried for diagnoses of operative CM-1 by International Classification of Di...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wolters Kluwer - Medknow
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7546047/ https://www.ncbi.nlm.nih.gov/pubmed/33100765 http://dx.doi.org/10.4103/jcvjs.JCVJS_69_20 |
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author | Passias, Peter G Naessig, Sara Para, Ashok Ahmad, Waleed Pierce, Katherine Janjua, M. Burhan Vira, Shaleen Sciubba, Daniel Diebo, Bassel |
author_facet | Passias, Peter G Naessig, Sara Para, Ashok Ahmad, Waleed Pierce, Katherine Janjua, M. Burhan Vira, Shaleen Sciubba, Daniel Diebo, Bassel |
author_sort | Passias, Peter G |
collection | PubMed |
description | INTRODUCTION: This study aimed to identify complication trends of Chiari Malformation Type 1 patients (CM-1) for certain procedures and concomitant diagnoses on a national level. MATERIALS: The Kids’ Inpatient Database was queried for diagnoses of operative CM-1 by International Classification of Disease-9 codes (348.4). Differences in preoperative demographics and perioperative complication rates between patient cohorts were assessed using Pearson's Chi-squared test and t-test when necessary. Binary logistic regression was utilized to find significant factors associated with complication rate. Certain surgical procedures were analyzed for their relationship with postoperative outcomes. RESULTS: Thirteen thousand eight hundred and twelve CM-1 patients were identified with 8.2% suffering from a complication. From 2003 to 2012, the rate of complications for CM-1 pts decreased significantly (9.6%–5.1%) along with surgical rate (33.3%–28.6%), despite the increase in CM-1 diagnosis (36.3%–42.3%; all P < 0.05). CM-1 pts who had a complication were younger and had a lower invasiveness score; however, they had a larger Charlson Comorbidity Index than those who did not have a complication (all P < 0.05). CM-1 pts who experienced complications had a concurrent diagnosis of syringomyelia (7.1%), and also scoliosis (3.2%; all P < 0.05). CM-1 pts who did not have a complication had a greater rate of operation than those that had a complication (76.4% vs. 23.6% P < 0.05). The most common complications were nervous system related (2.8%), anemia (2.4%), and acute respiratory distress (2.1%). CM-1 pts that underwent an instrumented fusion (3.4% vs. 2.1%) had a greater complication rate as well as compared to those who underwent a craniotomy (23.2% vs. 19.1%; all P < 0.05). However, CM-1 pts that underwent a decompression had lower postoperative complications (21.3% vs. 28.9%; all P < 0.05). CONCLUSIONS: Chiari patients undergoing craniectomies as well as instrumented fusions are at a higher risk of postoperative complications especially when the instrumented fusions were performed on >4 levels. |
format | Online Article Text |
id | pubmed-7546047 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Wolters Kluwer - Medknow |
record_format | MEDLINE/PubMed |
spelling | pubmed-75460472020-10-22 Complication rates following Chiari malformation surgical management for Arnold–Chiari type I based on surgical variables: A national perspective Passias, Peter G Naessig, Sara Para, Ashok Ahmad, Waleed Pierce, Katherine Janjua, M. Burhan Vira, Shaleen Sciubba, Daniel Diebo, Bassel J Craniovertebr Junction Spine Original Article INTRODUCTION: This study aimed to identify complication trends of Chiari Malformation Type 1 patients (CM-1) for certain procedures and concomitant diagnoses on a national level. MATERIALS: The Kids’ Inpatient Database was queried for diagnoses of operative CM-1 by International Classification of Disease-9 codes (348.4). Differences in preoperative demographics and perioperative complication rates between patient cohorts were assessed using Pearson's Chi-squared test and t-test when necessary. Binary logistic regression was utilized to find significant factors associated with complication rate. Certain surgical procedures were analyzed for their relationship with postoperative outcomes. RESULTS: Thirteen thousand eight hundred and twelve CM-1 patients were identified with 8.2% suffering from a complication. From 2003 to 2012, the rate of complications for CM-1 pts decreased significantly (9.6%–5.1%) along with surgical rate (33.3%–28.6%), despite the increase in CM-1 diagnosis (36.3%–42.3%; all P < 0.05). CM-1 pts who had a complication were younger and had a lower invasiveness score; however, they had a larger Charlson Comorbidity Index than those who did not have a complication (all P < 0.05). CM-1 pts who experienced complications had a concurrent diagnosis of syringomyelia (7.1%), and also scoliosis (3.2%; all P < 0.05). CM-1 pts who did not have a complication had a greater rate of operation than those that had a complication (76.4% vs. 23.6% P < 0.05). The most common complications were nervous system related (2.8%), anemia (2.4%), and acute respiratory distress (2.1%). CM-1 pts that underwent an instrumented fusion (3.4% vs. 2.1%) had a greater complication rate as well as compared to those who underwent a craniotomy (23.2% vs. 19.1%; all P < 0.05). However, CM-1 pts that underwent a decompression had lower postoperative complications (21.3% vs. 28.9%; all P < 0.05). CONCLUSIONS: Chiari patients undergoing craniectomies as well as instrumented fusions are at a higher risk of postoperative complications especially when the instrumented fusions were performed on >4 levels. Wolters Kluwer - Medknow 2020 2020-08-14 /pmc/articles/PMC7546047/ /pubmed/33100765 http://dx.doi.org/10.4103/jcvjs.JCVJS_69_20 Text en Copyright: © 2020 Journal of Craniovertebral Junction and Spine http://creativecommons.org/licenses/by-nc-sa/4.0 This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms. |
spellingShingle | Original Article Passias, Peter G Naessig, Sara Para, Ashok Ahmad, Waleed Pierce, Katherine Janjua, M. Burhan Vira, Shaleen Sciubba, Daniel Diebo, Bassel Complication rates following Chiari malformation surgical management for Arnold–Chiari type I based on surgical variables: A national perspective |
title | Complication rates following Chiari malformation surgical management for Arnold–Chiari type I based on surgical variables: A national perspective |
title_full | Complication rates following Chiari malformation surgical management for Arnold–Chiari type I based on surgical variables: A national perspective |
title_fullStr | Complication rates following Chiari malformation surgical management for Arnold–Chiari type I based on surgical variables: A national perspective |
title_full_unstemmed | Complication rates following Chiari malformation surgical management for Arnold–Chiari type I based on surgical variables: A national perspective |
title_short | Complication rates following Chiari malformation surgical management for Arnold–Chiari type I based on surgical variables: A national perspective |
title_sort | complication rates following chiari malformation surgical management for arnold–chiari type i based on surgical variables: a national perspective |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7546047/ https://www.ncbi.nlm.nih.gov/pubmed/33100765 http://dx.doi.org/10.4103/jcvjs.JCVJS_69_20 |
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