Delayed extubation in spine surgery is associated with increased postoperative complications and hospital episode-based resource utilization

2022 ◽  
Vol 77 ◽  
pp. 110636
Author(s):  
Jonathan Gal ◽  
Samuel Hunter ◽  
David Reich ◽  
Eric Franz ◽  
Samuel DeMaria ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Resource Utilization ◽  
Spine Surgery ◽  
Hospital Episode ◽  
Delayed Extubation

scholarly journals Impact of Diabetes Mellitus on Cervical Spine Surgery for Ossification of the Posterior Longitudinal Ligament

2021 ◽  
Vol 10 (15) ◽  
pp. 3375
Author(s):  
Atsushi Kimura ◽  
Katsushi Takeshita ◽  
Toshitaka Yoshii ◽  
Satoru Egawa ◽  
Takashi Hirai ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Cervical Spine ◽  
Postoperative Complications ◽  
Spine Surgery ◽  
Posterior Longitudinal Ligament ◽  
Lower Extremity Function ◽  
Cervical Spine Surgery ◽  
The Impact

Ossification of the posterior longitudinal ligament (OPLL) is commonly associated with diabetes mellitus (DM); however, the impact of DM on cervical spine surgery for OPLL remains unclear. This study was performed to evaluate the influence of diabetes DM on the outcomes following cervical spine surgery for OPLL. In total, 478 patients with cervical OPLL who underwent surgical treatment were prospectively recruited from April 2015 to July 2017. Functional measurements were conducted at baseline and at 6 months, 1 year, and 2 years after surgery using JOA and JOACMEQ scores. The incidence of postoperative complications was categorized into early (≤30 days) and late (>30 days), depending on the time from surgery. From the initial group of 478 patients, 402 completed the 2-year follow-up and were included in the analysis. Of the 402 patients, 127 (32%) had DM as a comorbid disease. The overall incidence of postoperative complications was significantly higher in patients with DM than in patients without DM in both the early and late postoperative periods. The patients with DM had a significantly lower JOA score and JOACMEQ scores in the domains of lower extremity function and quality of life than those without DM at the 2-year follow-up.

Patterns and Impact of Electronic Health Records-Defined Depression Phenotypes in Spine Surgery

Neurosurgery ◽  
2021 ◽  
Author(s):  
Maxwell Boakye ◽  
Mayur Sharma ◽  
Shawn Adams ◽  
Thomas Chandler ◽  
Dengzhi Wang ◽  
...  
Keyword(s):  
Resource Utilization ◽  
Spine Surgery ◽  
Healthcare Resource Utilization ◽  
Care Utilization ◽  
Complication Rates ◽  
Psychiatric Condition ◽  
Opioid Use ◽  
International Classification Of Disease ◽  
Chronic Opioid Use ◽  
Poor Outcomes

Abstract BACKGROUND Preoperative depression is a risk factor for poor outcomes after spine surgery. OBJECTIVE To understand effects of depression on spine surgery outcomes and healthcare resource utilization. METHODS Using IBM’s MarketScan Database, we identified 52 480 patients who underwent spinal fusion. Retained patients were classified into 6 depression phenotype groups based on International Classification of Disease, 9th/10th Revision (ICD-9/10) codes and use/nonuse of antidepressant medications: major depressive disorder (MDD), other depression (OthDep), antidepressants for other psychiatric condition (PsychRx), antidepressants for physical (nonpsychiatric) condition (NoPsychRx), psychiatric condition only (PsychOnly), and no depression (NoDep). We analyzed baseline demographics, comorbidities, healthcare utilization/payments, and chronic opioid use. RESULTS Breakdown of groups in our cohort: MDD (15%), OthDep (12%), PsychRx (13%), NonPsychRx (15%), PsychOnly (12%), and NoDep (33%). Postsurgery: increased outpatient resource utilization, admissions, and medication refills at 1, 2, and 5 yr in the NoDep, PsychOnly, NonPsychRx, PsychRx, and OthDep groups, and highest in MDD. Postoperative opioid usage rates remained unchanged in MDD (44%) and OthDep (36%), and reduced in PsychRx (40%), NonPsychRx (31%), and PsychOnly (20%), with greatest reduction in NoDep (13%). Reoperation rates: 1 yr after index procedure, MDD, OthDep, PsychRx, NonPsychRx, and PsychOnly had more reoperations compared to NoDep, and same at 2 and 5 yr. In NoDep patients, 45% developed new depressive phenotype postsurgery. CONCLUSION EHR-defined classification allowed us to study in depth the effects of depression in spine surgery. This increased understanding of the interplay of mental health will help providers identify cohorts at risk for high complication rates, and health care utilization.

scholarly journals Correlating Psychological Comorbidities and Outcomes After Spine Surgery

2019 ◽  
Vol 10 (7) ◽  
pp. 929-939
Author(s):  
Keith L. Jackson ◽  
Jacob Rumley ◽  
Matthew Griffith ◽  
Uzondu Agochukwu ◽  
John DeVine
Keyword(s):  
Postoperative Complications ◽  
Literature Review ◽  
Spine Surgery ◽  
Surgical Outcomes ◽  
Relevant Literature ◽  
Psychological Disorders ◽  
Spinal Pain ◽  
Screening Tools ◽  
Screening Criteria ◽  
Psychological Comorbidities

Study Design: Literature review. Objective: The aim of this literature review is to examine the effects of psychological disorders on postoperative complications, surgical outcomes, and long-term narcotic use. We also hope to detail the value of preoperative identification and treatment of these pathologies. Methods: A series of systematic reviews of the relevant literature examining the effects of psychological disorders and spine surgery was conducted using PubMed and Cochrane databases. Results: Combined, the database queries yielded 2275 articles for consideration. After applying screening criteria, 96 articles were selected for inclusion. Patients with underlying psychological disease have higher rates of delirium, readmission, longer hospital stays, and higher rates of nonroutine discharge following spine surgery. They also have higher rates of chronic postoperative narcotic use and may experience worse surgical outcomes. Because of these defined issues, researchers have developed multiple screening tools to help identify patients with psychological disorders preoperatively for potential treatment. Treatment of these disorders prior to surgery may significantly improve surgical outcomes. Conclusion: Patients with psychological disorders represent a unique population with respect to their higher rates of spinal pain complaints, postoperative complications, and worsened functional outcomes. However, proper identification and treatment of these conditions prior to surgery may significantly improve many outcome measures in this population. Future investigations in this field should attempt to develop and validate current strategies to identify and treat individuals with psychological disorders before surgery to further improve outcomes.

Risk factors for delayed extubation in thoracic and lumbar spine surgery: a retrospective analysis of 135 patients

2013 ◽  
Vol 28 (2) ◽  
pp. 161-166 ◽  
Author(s):  
Fenghua Li ◽  
Reza Gorji ◽  
Richard Tallarico ◽  
Charles Dodds ◽  
Katharina Modes ◽  
...  
Keyword(s):  
Risk Factors ◽  
Lumbar Spine ◽  
Retrospective Analysis ◽  
Spine Surgery ◽  
Lumbar Spine Surgery ◽  
Thoracic And Lumbar Spine ◽  
Delayed Extubation

257. Persistent opioid use and resource utilization in spine surgery

2020 ◽  
Vol 20 (9) ◽  
pp. S127
Author(s):  
Kibum Kim ◽  
Jennifer Babin ◽  
Joseph E. Biskupiak ◽  
Mary Helen Tran
Keyword(s):  
Resource Utilization ◽  
Spine Surgery ◽  
Opioid Use

Usefulness of Timed Up and Go (TUG) Test for Prediction of Adverse Outcomes in Patients Undergoing Thoracolumbar Spine Surgery

Neurosurgery ◽  
2019 ◽  
Vol 86 (3) ◽  
pp. E273-E280
Author(s):  
Gregoris Komodikis ◽  
Vedavyas Gannamani ◽  
Sivaram Neppala ◽  
Michael Li ◽  
Geno J Merli ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Spine Surgery ◽  
Test Performance ◽  
Tertiary Care ◽  
Skilled Nursing Facility ◽  
Thoracolumbar Spine ◽  
Adverse Outcomes ◽  
Care Hospital ◽  
High Grade ◽  
Timed Up And Go

Abstract BACKGROUND Spine surgery rates have increased and the high postoperative morbidity in these patients result in increased costs. Consequently, it is essential to identify patients at risk of adverse outcomes. OBJECTIVE To assess whether preoperative Timed Up and Go (TUG) test performance can predict high-grade postoperative complications. METHODS A prospective cohort study of patients undergoing elective thoracolumbar spine surgery in a tertiary care hospital between 2017 and 2018. Patients were assessed preoperatively and assigned to the slow-TUG group if unable to perform or test performance time was ≥18.4 s. Primary outcome: high-grade postoperative complications. Secondary outcomes: overall complications, length of stay (LOS), discharge to healthcare facility, readmission and emergency department (ED) presentation. Patients were followed-up until 6 wk after surgery. RESULTS One hundred three patients (mean age 62.95 ± 10.97 yr) were enrolled. Slow-TUG group were more likely to be classified as American Society of Anaesthesiology (ASA) class 3 (74.1% vs 47.4%, P = .02), non-independent (25.9% vs 5.3%, P < .01), and frail (92.3% vs 42.1%, P < .01). TUG was an independent predictor of high-grade complications (adjusted odds ratio (OR): 4.97, 95% CI: 1.18-22.47), overall complications (OR: 3.77, 95% CI: 1.33-11.81), discharge to a skilled-nursing facility (OR: 3.2, 95% CI: 1.00-10.70), readmission within 6 wk of surgery (OR: 9.14, 95% CI: 2.39-41.26) and LOS (adjusted incident rate ratio (IRR): 1.45, 95% CI: 1.16-1.80). CONCLUSION Compared to traditional risk factors, TUG is an important predictor of adverse postoperative outcomes and may be used preoperatively to identify high-risk thoracolumbar surgery patients.

2016 Research Grant Award Winner: The severity of preoperative HbA1c and predicting postoperative complications in spine surgery

2020 ◽  
Vol 20 (9) ◽  
pp. S32
Author(s):  
Tomoko Tanaka ◽  
Toby Bradford ◽  
Michael Gardner ◽  
Norman S. Litofsky
Keyword(s):  
Postoperative Complications ◽  
Spine Surgery ◽  
Award Winner ◽  
Research Grant
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