scholarly journals Demographic Predictors of Treatment and Complications for Spinal Disorders: Part 2, Lumbar Spine Trauma

Neurospine ◽  
2021 ◽  
Vol 18 (4) ◽  
pp. 725-732
Author(s):  
Omar Al Jammal ◽  
Julian Gendreau ◽  
Bejan Alvandi ◽  
Neal A. Patel ◽  
Nolan J. Brown ◽  
...  
Keyword(s):  
Lumbar Spine ◽  
Postoperative Complication ◽  
Surgical Management ◽  
Traumatic Injury ◽  
Demographic Factors ◽  
Complication Rates ◽  
Spine Trauma ◽  
Teaching Status ◽  
The Impact ◽  
To Receive

Objective: To study the impact of demographic factors on management of traumatic injury to the lumbar spine and postoperative complication rates.Methods: Data was obtained from the National Inpatient Sample (NIS) between 2010–2014. International Classification of Diseases, 9th revision, Clinical Modification codes identified patients diagnosed with lumbar fractures or dislocations due to trauma. A series of multivariate regression models determined whether demographic variables predicted rates of complication and revision surgery.Results: A total of 38,249 patients were identified. Female patients were less likely to receive surgery and to receive a fusion when undergoing surgery, had higher complication rates, and more likely to undergo revision surgery. Medicare and Medicaid patients were less likely to receive surgical management for lumbar spine trauma and less likely to receive a fusion when operated on. Additionally, we found significant differences in surgical management and postoperative complication rates based on race, insurance type, hospital teaching status, and geography.Conclusion: Substantial differences in the surgical management of traumatic injury to the lumbar spine, including postoperative complications, among individuals of demographic factors such as age, sex, race, primary insurance, hospital teaching status, and geographic region suggest the need for further studies to understand how patient demographics influence management and complications for traumatic injury to the lumbar spine.

scholarly journals The influence of smoking in minimally invasive spinal fusion surgery

Open Medicine ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. 198-206
Author(s):  
Wolfgang Senker ◽  
Harald Stefanits ◽  
Matthias Gmeiner ◽  
Wolfgang Trutschnig ◽  
Christian Radl ◽  
...  
Keyword(s):  
Lumbar Spine ◽  
Minimally Invasive ◽  
Postoperative Complication ◽  
Complication Rate ◽  
Clinical Effectiveness ◽  
Complication Rates ◽  
Spinal Fusion Surgery ◽  
The Difference ◽  
A Prospective Study ◽  
The Impact

Abstract Background The impact of smoking on spinal surgery has been studied extensively, but few investigations have focused on minimally invasive surgery (MIS) of the spine and the difference between complication rates in smokers and non-smokers. We evaluated whether a history of at least one pack-year preoperatively could be used to predict adverse peri- and postoperative outcomes in patients undergoing minimally invasive fusion procedures of the lumbar spine. In a prospective study, we assessed the clinical effectiveness of MIS in an unselected population of 187 patients. Methods We evaluated perioperative and postoperative complication rates in MIS fusion techniques of the lumbar spine in smoking and non-smoking patients. MIS fusion was performed using interbody fusion procedures and/or posterolateral fusion alone. Results Smokers were significantly younger than non-smokers. We did not encounter infection at the site of surgery or severe wound healing disorder in smokers. We registered no difference between the smoking and non-smoking groups with regard to peri- or postoperative complication rate, blood loss, or length of stay in hospital. We found a significant influence of smoking (p = 0.049) on the overall perioperative complication rate. Conclusion MIS fusion techniques seem to be a suitable tool for treating degenerative spinal disorders in smokers.

scholarly journals Impact of SARS-Cov-2 on ectopic pregnancies management in the United Kingdom: a multicentre paired observational study

2020 ◽  
Author(s):  
Sophie Platts ◽  
Jeewantha Ranawakagedon ◽  
Reeba Oliver ◽  
Sayantana Das ◽  
Phalguni Kotabagi ◽  
...  
Keyword(s):  
Ectopic Pregnancy ◽  
Surgical Management ◽  
Expectant Management ◽  
Complication Rates ◽  
University Hospitals ◽  
Length Of Treatment ◽  
Hospital Visits ◽  
Ectopic Pregnancies ◽  
The Impact ◽  
Pregnancy Registry

Objective: to describe the impact of COVID-19 on the management of patients with ectopic pregnancy. Design: a multicentre study comparing outcomes from a prospective cohort during the pandemic [Covid-ectopic pregnancy registry (CEPR)] compared to an historical pre-pandemic cohort [non-Covid ectopic pregnancy registry (NCEPR)]. Setting: five London university hospitals. Population and Methods: consecutive patients diagnosed clinically and/or radiologically with ectopic pregnancy (March/2020-Aug/2020) were entered into the CEPR and an exploratory matched analysis was performed comparing results to NCEPR patients (January/2019-June/2019). Main outcome measures: patient demographics, management (expectant, medical and surgical), length of treatment, number of hospital visits (non-surgical management), length of stay (surgical management) and 30-day complications. Results: 341 patients met inclusion: 162 CEPR and 179 NCEPR. A significantly higher percentage of women underwent non-surgical management versus surgical management in the CEPR versus NCEPR (58.6% [95/162] vs 72.6% [130/179]; p= 0.0084]. Amongst patients managed with expectant management the CEPR had a significantly lower mean number of hospital visits compared to NCEPR [3.6 [SD 1.4] vs 13.7 [SD 13.4], p= 0.0053]. Amongst patients managed with medical management, the CEPR had a significantly lower mean number of hospital visits [NCEPR 6.4 [SD 2.3] vs 8.8 [SD 3.9], p= 0.0014]. There was no observed difference in complication rates between cohorts. Conclusion: women were found to undergo significantly higher rates of non-surgical management during COVID-19 first wave vs NCEPR cohort. Women managed non-surgically in CPER cohort were also managed with fewer hospital attendances. This did not lead to an increase in observed complications rates.

scholarly journals Classifying Complications: Assessing Adult Spinal Deformity 2-Year Surgical Outcomes

2020 ◽  
Vol 10 (7) ◽  
pp. 896-907
Author(s):  
Eric O. Klineberg ◽  
Peter G. Passias ◽  
Gregory W. Poorman ◽  
Cyrus M. Jalai ◽  
Abiola Atanda ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Postoperative Complication ◽  
Spinal Deformity ◽  
Surgical Outcomes ◽  
Perioperative Complications ◽  
Adult Spinal Deformity ◽  
Complication Rates ◽  
Estimated Blood Loss ◽  
Patient Reported ◽  
The Impact

Study Design: Retrospective review of prospective database. Objective: Complication rates for adult spinal deformity (ASD) surgery vary widely because there is no accepted system for categorization. Our objective was to identify the impact of complication occurrence, minor-major complication, and Clavien-Dindo complication classification (Cc) on clinical variables and patient-reported outcomes. Methods: Complications in surgical ASD patients with complete baseline and 2-year data were considered intraoperatively, perioperatively (<6 weeks), and postoperatively (>6 weeks). Primary outcome measures were complication timing and severity according to 3 scales: complication presence (yes/no), minor-major, and Cc score. Secondary outcomes were surgical outcomes (estimated blood loss [EBL], length of stay [LOS], reoperation) and health-related quality of life (HRQL) scores. Univariate analyses determined complication presence, type, and Cc grade impact on operative variables and on HRQL scores. Results: Of 167 patients, 30.5% (n = 51) had intraoperative, 48.5% (n = 81) had perioperative, and 58.7% (n = 98) had postoperative complications. Major intraoperative complications were associated with increased EBL ( P < .001) and LOS ( P = .0092). Postoperative complication presence and major postoperative complication were associated with reoperation ( P < .001). At 2 years, major perioperative complications were associated with worse ODI, SF-36, and SRS activity and appearance scores ( P < .02). Increasing perioperative Cc score and postoperative complication presence were the best predictors of worse HRQL outcomes ( P < .05). Conclusion: The Cc Scale was most useful in predicting changes in patient outcomes; at 2 years, patients with raised perioperative Cc scores and postoperative complications saw reduced HRQL improvement. Intraoperative and perioperative complications were associated with worse short-term surgical and inpatient outcomes.

Can Surgeon Demographic Factors Predict Postoperative Complication Rates After Elective Spinal Fusion?

2018 ◽  
Vol 31 (2) ◽  
pp. 93-97 ◽  
Author(s):  
Danielle S. Chun ◽  
Ralph W. Cook ◽  
Joseph A. Weiner ◽  
Michael S. Schallmo ◽  
Kathryn A. Barth ◽  
...  
Keyword(s):  
Postoperative Complication ◽  
Spinal Fusion ◽  
Demographic Factors ◽  
Complication Rates

Perioperative outcomes of aspirin use in radical prostatectomy.

2018 ◽  
Vol 36 (6_suppl) ◽  
pp. 150-150
Author(s):  
Matthew D. Ingham ◽  
Ross E Krasnow ◽  
Matthew Mossanen ◽  
Ye Wang ◽  
Steven Lee Chang
Keyword(s):  
Radical Prostatectomy ◽  
Minimally Invasive ◽  
Major Complication ◽  
Perioperative Outcomes ◽  
Complication Rates ◽  
Hospital Outcomes ◽  
Group 2 ◽  
The Impact ◽  
To Receive ◽  
Group 1

150 Background: Increasing cardiovascular disease has led to increases in the patient population on anti-platelet therapy who require urologic surgery. We sought to study perioperative outcomes for those undergoing radical prostatectomy (RP) while taking or not taking perioperative aspirin (pASA). Methods: A retrospective review of patients undergoing RP was performed on the Premier Hospital Database from 2003 to 2015, with survey projection weighting resulting in a cohort of 157,674 patients. Two groups were formed – those continued on pASA (group 1, n = 4400) and those with no pASA (group 2, n = 153,274). In-hospital complication rates were studied: major bleeding, overall transfusion, day-of-surgery transfusion, prolonged ( > 4 days) length of stay (LOS), and prolonged ( > 285 minutes) operative time. We also assessed 90-day rates of: cardiovascular catastrophe, readmission, major complication, and DVT/PE. Unadjusted rates were calculated for all RP patients and further subdivided into open and minimally invasive RP. Adjusted odds ratios (OR) were then calculated between groups 1 and 2. Results: Group 1 was older (51.5% vs 41.8% ≥65 years, p = 0.002) and less healthy (13.8% vs 5.3% with a CCI score ≥2, p < 0.0001) vs those in group 2. Group 1 patients were more likely to receive an open RP (42.3% vs 28.1%, p < 0.0001). For in-hospital outcomes for all RPs, no significant differences were noted regardless of surgical approach. For 90-day outcomes, those in group 1 were more likely to suffer a MI (OR 5.88, CI [3.4-10.18], p < 0.001), major complication (OR2.95, CI [1.58-5.5], p < 0.001), or be readmitted (OR 1.63, CI [1.18-2.26], p < 0.05). The disparity in both MI and major complication rates appeared to be largely driven by those undergoing minimally invasive RPs, with an OR of 7.92 and 4.02 noted, respectively. Conclusions: This large, retrospective, database review of both academic and community hospitals provides an important assessment of the impact pASA has on RP outcomes. In-hospital outcomes were equivalent between groups but those on pASA saw increased rates of MI, major complication, and readmission. Despite this, this study lends support to the belief that pASA should likely not be considered an absolute contraindication to RP.

The Impact of Groin Surgery during Childhood on the Incidence of Inguinal Hernia Repair and Its Postoperative Complications in Adult Life

2018 ◽  
Vol 29 (03) ◽  
pp. 271-275
Author(s):  
Arestis Sokratous ◽  
Johanna Österberg ◽  
Gabriel Sandblom
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Postoperative Complication ◽  
Inguinal Hernia Repair ◽  
Adult Life ◽  
Operation Time ◽  
Study Cohort ◽  
Complication Rates ◽  
Increased Risk ◽  
The Impact

Background Pediatric inguinal hernia, hydrocele, and cryptorchidism are common congenital anomalies affecting children, and require surgical intervention in some cases. The association between surgical treatment of these conditions and acquired inguinal hernia later in life is poorly understood. The aim of this cohort study was to examine the effect of groin surgery during childhood on the incidence and surgical outcome of inguinal hernia repair in adult life. Materials and Methods Data from the Swedish Inpatient Register and the Swedish Hernia Register were cross-linked using the patient personal identity numbers. The incidence of inguinal hernia repair in patients 15 years or older in the study cohort, as well as postoperative complication rates, were compared with the expected incidence and complication rates extrapolated from the general Swedish population in 2014, stratifying for age and gender. Results Note that 68,238 children aged 0 to 14 years were found to have undergone groin surgery between 1964 and 1998. The median follow-up time after an operation in the groin was 30.8 years (21.0–50.0). Of those, 1,118 were found to have undergone inguinal hernia repair as adults (> 15 years old) between 1992 and 2013. The incidence of inguinal hernia repair in the cohort was significantly higher than that expected (1.43 [1.33–1.53]), both for men (1.32 [1.25–1.41]) and women (4.30 [3.28–5.55]). The incidence was also increased in the subgroup of patients that had undergone more than one procedure during childhood. No significant impact on postoperative complication rate, reoperation rate, or operation time was identified. Conclusion Individuals undergoing surgery in the groin during childhood are at increased risk for acquired inguinal hernia surgery later in life. Inguinal surgery during childhood did not affect the outcome of hernia repair in adult age.

Peranan Whistleblowing Dalam Meningkatkan Integriti Anggota Polis Diraja Malaysia (Pdrm): Kajian Ke Atas Kontinjen Perak

Sains Insani ◽  
2018 ◽  
Vol 2 (1) ◽  
pp. 17-27
Author(s):  
Megat Ayop Megat Arifin ◽  
Abd. Halim Ahmad
Keyword(s):  
Quantitative Analysis ◽  
Demographic Factors ◽  
Positive Perception ◽  
External Threats ◽  
Positive Practices ◽  
The Impact ◽  
The Relationship

Whitsleblowing is one of the positive practices in organizations that are able to raise the level of integrity among the members of an organization. However, the roles of whistleblowing also inevitably invites a response, especially among members of the organization itself. This is because such practices are viewed as one factor that may be detrimental to the organization in addition to revealing the reporter (whistleblower) to some external threats and intimidation of discrimination within the organization. This paper is an attempt to examine the relationship between perceptions of members of the Royal Malaysian Police (RMP) Contingent of Perak through the role of whistleblowing practices to increase the perception of the integrity of the members. Next, identify the purpose of the whistleblowing and its effect on the integrity of the members of the organization. This study used a descriptive quantitative analysis to identify patterns of relationship that exists between the perception of whistleblowing practices with perceptions of increased integrity based on three basic variables of demographic factors, response to whistleblowing and the impact of making the report. The results showed that members of the Perak’s police have a positive perception of whistleblowing practices which are seen to be done in improving the integrity of the members.Keywords: whistleblowing, perception, RMP members, culture, integrity, organization, influence. ABSTRAK: Whitsleblowing merupakan salah satu amalan positif dalam organisasi yang mampu untuk meningkatkan tahap integriti ahli-ahli dalam sesebuah organisasi. Namun begitu, amalan whistleblowing juga turut tidak dapat mengelak daripada mengundang pelbagai respon khususnya dalam kalangan ahli organisasi itu sendiri. Amalan sebegini turut dilihat sebagai salah satu faktor yang boleh memudaratkan organisasi di samping mendedahkan pelapor (whistleblower) kepada beberapa bentuk ancaman ugutan dari luar dan diskriminasi dalam organisasi. Kertas ini merupakan satu upaya untuk melihat perkaitan antara persepsi anggota Polis Diraja Malaysia (PDRM) Kontinjen Perak melalui peranan amalan whistleblowing terhadap persepsi peningkatan integriti anggota. Seterusnya, mengenalpasti maksud whistleblowing dan pengaruhnya terhadap tahap integriti anggota dalam organisasi. Kajian ini menggunakan analisis kuantitatif berbentuk deskriptif bagi mengenalpasti corak hubungan yang wujud antara persepsi terhadap amalan whistleblowing dengan persepsi terhadap peningkatan integriti berdasarkan tiga pembolehubah asas iaitu faktor demografi, tanggapan terhadap whistleblowing dan kesan daripada tindakan membuat laporan. Dapatan kajian menunjukkan bahawa anggota PDRM Perak mempunyai persepsi yang positif terhadap whistleblowing yang mana ianya dilihat perlu dilaksanakan dalam meningkatkan integriti anggota.Kata kunci: whistleblowing, persepsi, amalan, anggota PDRM, budaya, integriti, organisasi, pengaruh.  

Multiple subluxations and comminuted fracture of the cervical spine in a sheep

2015 ◽  
Vol 43 (01) ◽  
pp. 44-38
Author(s):  
C.-C. Lin ◽  
K.-S. Chen ◽  
Y.-L. Lin ◽  
J. P.-W. Chan
Keyword(s):  
Cervical Spine ◽  
Pain Perception ◽  
Cervical Vertebrae ◽  
Traumatic Injury ◽  
Spinal Reflexes ◽  
Spine Trauma ◽  
Blunt Force Trauma ◽  
Comminuted Fracture ◽  
History Of ◽  
The Right

SummaryA 5-month-old, 13.5 kg, female Corriedale sheep was referred to the Veterinary Medicine Teaching Hospital, with a history of traumatic injury of the cervical spine followed by non-ambulatoric tetraparesis that occurred 2 weeks before being admitted to the hospital. At admission, malalignment of the cervical spine with the cranial part of the neck deviating to the right was noted. Neurological examinations identified the absence of postural reactions in both forelimbs, mildly decreased spinal reflexes, and normal reaction to pain perception tests. Radiography revealed malalignment of the cervical vertebrae with subluxations at C1–C2 and C2–C3, and a comminuted fracture of the caudal aspect of C2. The sheep was euthanized due to a presumed poor prognosis. Necropsy and histopathological findings confirmed injuries of the cervical spine from C1 to C3, which were consistent with the clinical finding of tetraparesis in this case. This paper presents a rare case of multiple subluxations of the cervical spine caused by blunt force trauma in a young sheep. These results highlight the importance of an astute clinical diagnosis for such an acute cervical spine trauma and the need for prompt surgical correction for similar cases in the future.

Sign in / Sign up

Export Citation Format

Share Document