Prolonged operative time significantly impacts on the incidence of complications in spinal surgery.


Journal

Journal of orthopaedic surgery and research
ISSN: 1749-799X
Titre abrégé: J Orthop Surg Res
Pays: England
ID NLM: 101265112

Informations de publication

Date de publication:
14 Sep 2024
Historique:
received: 04 07 2024
accepted: 07 09 2024
medline: 14 9 2024
pubmed: 14 9 2024
entrez: 13 9 2024
Statut: epublish

Résumé

In spinal surgery adverse events (AE) and surgical complications (SC) significantly affect patient's outcome and quality of life. The duration of surgery has been investigated in different surgical field as risk factor for complications. The aim of this study is to analyze the correlation between operative time and adverse events in spinal surgery. We retrospectively analyzed data collected prospectively in a cohort of 336 patients surgically treated for spinal diseases of oncological and degenerative origin in a single center, between January 2017 to January 2018. Demographics and clinical data were collected. Adverse events were classified using Spinal Adverse Events Severity System version 2 (SAVES-V2) capture system. Focusing on degenerative patients, bivariate analysis and univariate logistic regression were used to determine the association between operative time and complications. A total of 105/336 patients experienced an AE related to surgery, respectively 38% in the oncological group and 28% in the degenerative group. The average age at surgery was 60.3 years (SD 17.1) and the mean operative time was 164.8 ± 138 min. A total of 206 adverse events (30 intraoperative, 135 early postoperative and 41 late postoperative AEs) were recorded. Early post-operative complications accounted for the most recorded AEs (55.5% in the oncological group and 73.2% in the degenerative group). Univariate logistic regression analyses confirmed that operative time correlated with increased risk of intra-operative (p-value = 0.0008), early post-operative (p-value < 0.001) and late post-operative (p-value < 0.001) adverse events. This study highlights the strong correlation between the occurrence of adverse events in spinal surgery and prolonged operative time and suggests that efforts should be made to minimize the duration of surgical procedures while prioritizing patient's safety, without compromising the technical achievement of the procedure.

Sections du résumé

BACKGROUND BACKGROUND
In spinal surgery adverse events (AE) and surgical complications (SC) significantly affect patient's outcome and quality of life. The duration of surgery has been investigated in different surgical field as risk factor for complications. The aim of this study is to analyze the correlation between operative time and adverse events in spinal surgery.
METHODS METHODS
We retrospectively analyzed data collected prospectively in a cohort of 336 patients surgically treated for spinal diseases of oncological and degenerative origin in a single center, between January 2017 to January 2018. Demographics and clinical data were collected. Adverse events were classified using Spinal Adverse Events Severity System version 2 (SAVES-V2) capture system. Focusing on degenerative patients, bivariate analysis and univariate logistic regression were used to determine the association between operative time and complications.
RESULTS RESULTS
A total of 105/336 patients experienced an AE related to surgery, respectively 38% in the oncological group and 28% in the degenerative group. The average age at surgery was 60.3 years (SD 17.1) and the mean operative time was 164.8 ± 138 min. A total of 206 adverse events (30 intraoperative, 135 early postoperative and 41 late postoperative AEs) were recorded. Early post-operative complications accounted for the most recorded AEs (55.5% in the oncological group and 73.2% in the degenerative group). Univariate logistic regression analyses confirmed that operative time correlated with increased risk of intra-operative (p-value = 0.0008), early post-operative (p-value < 0.001) and late post-operative (p-value < 0.001) adverse events.
CONCLUSIONS CONCLUSIONS
This study highlights the strong correlation between the occurrence of adverse events in spinal surgery and prolonged operative time and suggests that efforts should be made to minimize the duration of surgical procedures while prioritizing patient's safety, without compromising the technical achievement of the procedure.

Identifiants

pubmed: 39272113
doi: 10.1186/s13018-024-05066-3
pii: 10.1186/s13018-024-05066-3
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

567

Informations de copyright

© 2024. The Author(s).

Références

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Auteurs

Annalisa Monetta (A)

Department of Spine Surgery, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy.

Cristiana Griffoni (C)

Department of Spine Surgery, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy. cristiana.griffoni@ior.it.

Luigi Falzetti (L)

Department of Spine Surgery, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy.

Gisberto Evangelisti (G)

Department of Spine Surgery, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy.

Luigi Emanuele Noli (LE)

Department of Spine Surgery, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy.
ISNB Istituto delle Scienze Neurologiche di Bologna, Via Altura,3, Bologna, 40139, Italy.

Giuseppe Tedesco (G)

Department of Spine Surgery, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy.

Carlotta Cavallari (C)

Department of Spine Surgery, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy.

Stefano Bandiera (S)

Department of Spine Surgery, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy.

Silvia Terzi (S)

Department of Spine Surgery, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy.

Riccardo Ghermandi (R)

Department of Spine Surgery, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy.

Marco Girolami (M)

Department of Spine Surgery, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy.

Valerio Pipola (V)

Department of Spine Surgery, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy.

Alessandro Gasbarrini (A)

Department of Spine Surgery, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy.
Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy.

Giovanni Barbanti Brodano (GB)

Department of Spine Surgery, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy.

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