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The effect of surgical time on perioperative complications in adolescent idiopathic scoliosis cases. A propensity score analysis.
Noe, McKenna C; Hagaman, Daniel; Sipp, Brittany; Qureshi, Fahad; Warren, Jonathan R; Kaji, Ellie; Sherman, Ashley; Schwend, Richard M.
Afiliación
  • Noe MC; Department of Orthopaedic Surgery, Children's Mercy Kansas City, 2401 Gillham Road, Kansas City, MO, 64108, USA.
  • Hagaman D; Department of Orthopaedic Surgery, University of Missouri Kansas City, Kansas City, MO, USA.
  • Sipp B; Department of Surgery, University of Missouri Kansas City, Kansas City, MO, USA.
  • Qureshi F; Department of Interventional Radiology, Loma Linda University, Loma Linda, CA, USA.
  • Warren JR; Department of Orthopaedic Surgery, Children's Mercy Kansas City, 2401 Gillham Road, Kansas City, MO, 64108, USA.
  • Kaji E; Department of Orthopaedic Surgery, University of Missouri Kansas City, Kansas City, MO, USA.
  • Sherman A; University of Missouri Kansas City School of Medicine, Kansas City, MO, USA.
  • Schwend RM; Department of Orthopaedic Surgery, Children's Mercy Kansas City, 2401 Gillham Road, Kansas City, MO, 64108, USA.
Spine Deform ; 12(4): 1053-1060, 2024 Jul.
Article en En | MEDLINE | ID: mdl-38492171
ABSTRACT

BACKGROUND:

Posterior spinal instrumentation and fusion (PSIF) for adolescent idiopathic scoliosis (AIS) can be lengthy and complication-ridden. The aim of this study was to evaluate the effect of surgical time on perioperative complications in this procedure when controlling for confounding variables with propensity score analysis.

METHODS:

This was an IRB-approved review of electronic health records from 2010 to 2019 at a single tertiary care children's hospital. Patients undergoing PSIF were grouped into "short" (< 6 h) or "long" (≥ 6 h) surgical time groups. Outcome measures were estimated blood loss (EBL), cell saver transfusions, packed red blood cell (pRBC) transfusions, length of stay (LOS), intraoperative monitoring (IOM) alerts, hematocrit, ICU transfer, neurologic loss, surgical site infection, and 90-day readmissions. We controlled for age, sex, BMI, curve severity, number of segments fused, and surgeon factors.

RESULTS:

After propensity score matching there were 113 patients in each group. The short surgical time group had lower EBL (median 715, IQR 550-900 vs median 875, IQR 650-1100 cc; p < 0.001), received less cell saver blood (median 120, IQR 60-168 vs median 160, IQR 97-225 cc; p = 0.001), received less intraoperative pRBCs (median 0, IQR 0-0 vs median 0, IQR 0-320, p = 0.002), had shorter average LOS (4.8 ± 1.7 vs 5.4 ± 2.5 days; p = 0.039), and fewer IOM alerts (4.3% vs 18%, p = 0.003).

CONCLUSIONS:

Patients with shorter surgical times had less blood loss, received less transfused blood, had a shorter LOS, and fewer IOM alerts compared to patients with longer surgical times. Surgical times < 6 h may have safety and efficacy advantages over longer times. LEVEL OF EVIDENCE III.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Complicaciones Posoperatorias / Escoliosis / Fusión Vertebral / Puntaje de Propensión / Tempo Operativo Límite: Adolescent / Child / Female / Humans / Male Idioma: En Revista: Spine Deform Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Complicaciones Posoperatorias / Escoliosis / Fusión Vertebral / Puntaje de Propensión / Tempo Operativo Límite: Adolescent / Child / Female / Humans / Male Idioma: En Revista: Spine Deform Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido