Abstract
We developed a predictive model to describe risk factors for complications in cervical deformity surgeries. Cervical deformity (CD) surgical patients are growing in number, but remain under-studied in the literature. CD was defined as at least one of the following: C2–C7 Cobb >10° CL >10° cSVA >4 cm, CBVA >25°. Patient demographics and clinical data were assessed as risk factors for medical/surgical complications using multivariate regression models. 123 patients underwent CD surgery (60.6 yrs, 60.8% F). The most common complications were neurologic (24.4%), dysphagia (13.0%), cardiopulmonary (11.4%), infection (9.7%). 51 (41.5%) of patients experienced a medical complication and 73 (59.3%) had a surgical complication. An overall complication was predicted with high accuracy (AUC = 0.79) by the following combinations of factors: higher baseline EQ5D pain and lower baseline EQ5D anxiety/depression scores, and higher cervical and global SVA. A medical complication can be predicted by male gender, baseline mJOA score, and cervical SVA (AUC = 0.770). A surgical complication can be predicted by higher estimated blood loss, lower anxiety scores, and larger global SVA (AUC = 0.739). 64.2% of patients undergoing cervical deformity correction sustained any complication. While the most reliable predictor of the occurrence of a complication involved a cluster of risk factors, a radiographic baseline sagittal parameter of cervical SVA was the strongest isolated predictor for complications across categories. Although these findings are specific to a cervical population with moderate to severe deformities, collectively they can be utilized for pre-operative risk assessment and patient education.
| Original language | English (US) |
|---|---|
| Journal | Journal of Clinical Neuroscience |
| DOIs | |
| State | Accepted/In press - Jan 1 2018 |
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Keywords
- Cervical deformity
- Clinical outcomes
- Health-related quality of life scores
- Medical complications
- Predictive model
- Surgical complications
- Surgical correction
ASJC Scopus subject areas
- Surgery
- Neurology
- Clinical Neurology
- Physiology (medical)
Cite this
Predicting the occurrence of complications following corrective cervical deformity surgery : Analysis of a prospective multicenter database using predictive analytics. / International Spine Study Group.
In: Journal of Clinical Neuroscience, 01.01.2018.Research output: Contribution to journal › Article
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TY - JOUR
T1 - Predicting the occurrence of complications following corrective cervical deformity surgery
T2 - Analysis of a prospective multicenter database using predictive analytics
AU - International Spine Study Group.
AU - Passias, Peter G.
AU - Oh, Cheongeun
AU - Horn, Samantha R.
AU - Kim, Han Jo
AU - Hamilton, D. Kojo
AU - Sciubba, Daniel M.
AU - Neuman, Brian J.
AU - Buckland, Aaron J.
AU - Poorman, Gregory W.
AU - Segreto, Frank A.
AU - Bortz, Cole A.
AU - Brown, Avery E.
AU - Protopsaltis, Themistocles S.
AU - Klineberg, Eric Otto
AU - Ames, Christopher
AU - Smith, Justin S.
AU - Lafage, Virginie
PY - 2018/1/1
Y1 - 2018/1/1
N2 - We developed a predictive model to describe risk factors for complications in cervical deformity surgeries. Cervical deformity (CD) surgical patients are growing in number, but remain under-studied in the literature. CD was defined as at least one of the following: C2–C7 Cobb >10° CL >10° cSVA >4 cm, CBVA >25°. Patient demographics and clinical data were assessed as risk factors for medical/surgical complications using multivariate regression models. 123 patients underwent CD surgery (60.6 yrs, 60.8% F). The most common complications were neurologic (24.4%), dysphagia (13.0%), cardiopulmonary (11.4%), infection (9.7%). 51 (41.5%) of patients experienced a medical complication and 73 (59.3%) had a surgical complication. An overall complication was predicted with high accuracy (AUC = 0.79) by the following combinations of factors: higher baseline EQ5D pain and lower baseline EQ5D anxiety/depression scores, and higher cervical and global SVA. A medical complication can be predicted by male gender, baseline mJOA score, and cervical SVA (AUC = 0.770). A surgical complication can be predicted by higher estimated blood loss, lower anxiety scores, and larger global SVA (AUC = 0.739). 64.2% of patients undergoing cervical deformity correction sustained any complication. While the most reliable predictor of the occurrence of a complication involved a cluster of risk factors, a radiographic baseline sagittal parameter of cervical SVA was the strongest isolated predictor for complications across categories. Although these findings are specific to a cervical population with moderate to severe deformities, collectively they can be utilized for pre-operative risk assessment and patient education.
AB - We developed a predictive model to describe risk factors for complications in cervical deformity surgeries. Cervical deformity (CD) surgical patients are growing in number, but remain under-studied in the literature. CD was defined as at least one of the following: C2–C7 Cobb >10° CL >10° cSVA >4 cm, CBVA >25°. Patient demographics and clinical data were assessed as risk factors for medical/surgical complications using multivariate regression models. 123 patients underwent CD surgery (60.6 yrs, 60.8% F). The most common complications were neurologic (24.4%), dysphagia (13.0%), cardiopulmonary (11.4%), infection (9.7%). 51 (41.5%) of patients experienced a medical complication and 73 (59.3%) had a surgical complication. An overall complication was predicted with high accuracy (AUC = 0.79) by the following combinations of factors: higher baseline EQ5D pain and lower baseline EQ5D anxiety/depression scores, and higher cervical and global SVA. A medical complication can be predicted by male gender, baseline mJOA score, and cervical SVA (AUC = 0.770). A surgical complication can be predicted by higher estimated blood loss, lower anxiety scores, and larger global SVA (AUC = 0.739). 64.2% of patients undergoing cervical deformity correction sustained any complication. While the most reliable predictor of the occurrence of a complication involved a cluster of risk factors, a radiographic baseline sagittal parameter of cervical SVA was the strongest isolated predictor for complications across categories. Although these findings are specific to a cervical population with moderate to severe deformities, collectively they can be utilized for pre-operative risk assessment and patient education.
KW - Cervical deformity
KW - Clinical outcomes
KW - Health-related quality of life scores
KW - Medical complications
KW - Predictive model
KW - Surgical complications
KW - Surgical correction
UR - http://www.scopus.com/inward/record.url?scp=85056599522&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85056599522&partnerID=8YFLogxK
U2 - 10.1016/j.jocn.2018.10.111
DO - 10.1016/j.jocn.2018.10.111
M3 - Article
C2 - 30459012
AN - SCOPUS:85056599522
JO - Journal of Clinical Neuroscience
JF - Journal of Clinical Neuroscience
SN - 0967-5868
ER -