Morbidity and mortality in the surgical treatment of 10,329 adults with degenerative lumbar stenosis

Object The purpose of this study was to evaluate the prospectively collected Scoliosis Research Society (SRS) database to assess the incidences of morbidity and mortality (M&M) in the operative treatment of degenerative lumbar stenosis, one of the most common procedures performed by spine surgeons. Methods All patients who underwent surgical treatment for degenerative lumbar stenosis between 2004 and 2007 were identified from the SRS M&M database. Inclusion criteria for analysis included an age ≥ 21 years and no history of lumbar surgery. Patients were treated with either decompression alone or decompression with concomitant fusion. Statistical comparisons were performed using a 2-sided Fisher exact test. Results Of the 10,329 patients who met the inclusion criteria, 6609 (64%) were treated with decompression alone, and 3720 (36%) were treated with decompression and fusion. Among those who underwent fusion, instrumentation was placed in 3377 (91%). The overall mean patient age was 63 ± 13 years (range 21–96 years). Seven hundred nineteen complications (7.0%), including 13 deaths (0.1%), were identified. New neurological deficits were reported in 0.6% of patients. Deaths were related to cardiac (4 cases), respiratory (5 cases), pulmonary embolus (2 cases), and sepsis (1 case) etiologies, and a perforated gastric ulcer (1 case). Complication rates did not differ based on patient age or whether fusion was performed. Minimally invasive procedures were associated with fewer complications and fewer new neurological deficits (p = 0.01 and 0.03, respectively). Conclusions The results from this analysis of the SRS M&M database provide surgeons with useful information for preoperative counseling of patients contemplating surgical intervention for symptomatic degenerative lumbar stenosis.

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Chart review of diagnostic methods, baseline characteristics and symptoms for European patients with pancreatic cancer

Future Oncology ◽

10.2217/fon-2020-0749 ◽

2021 ◽

Vol 17 (15) ◽

pp. 1843-1854

Author(s):

Alfredo Carrato ◽

Davide Melisi ◽

Gerald Prager ◽

Christoph B Westphalen ◽

Anabel Ferreras ◽

...

Keyword(s):

Chart Review ◽

Diagnostic Technique ◽

Tumor Location ◽

Diagnostic Methods ◽

Ductal Adenocarcinoma ◽

Inclusion Criteria ◽

First Line ◽

Patient Age ◽

Patient Âgé ◽

Baseline Characteristics

Aim: To survey European physicians managing patients with metastatic pancreatic ductal adenocarcinoma (PDAC) and understand differences in baseline characteristics, diagnostic methods, symptoms and co-morbidities. Materials & methods: Patient record inclusion criteria were: ≥18 years old, metastatic PDAC diagnosis and completion of first-line treatment between July 2014 and January 2016. Records were grouped by patient age, gender and primary tumor location. Results: Records (n = 2565) were collected from nine countries. Baseline characteristics varied between subgroups. Computed tomography was the most frequently used diagnostic technique. Symptoms at diagnosis included abdominal and/or mid-back pain (72% of patients) and weight loss (61.5%). Co-morbidities varied with patient age. Conclusion: Greater awareness of symptoms, diagnostic methods and co-morbidities present at PDAC diagnosis may support better patient management decisions.

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Surgical treatment for brain metastases: Prognostic factors and survival in 309 patients with regard to patient age

Journal of Clinical Neuroscience ◽

10.1016/j.jocn.2010.03.046 ◽

2011 ◽

Vol 18 (1) ◽

pp. 34-38 ◽

Cited By ~ 23

Author(s):

A.M. Stark ◽

C. Stöhring ◽

J. Hedderich ◽

J. Held-Feindt ◽

H.M. Mehdorn

Keyword(s):

Prognostic Factors ◽

Surgical Treatment ◽

Brain Metastases ◽

Patient Age ◽

Patient Âgé

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Complications Associated with Surgical Treatment of Traumatic Spinal Fractures: A Review of the Scoliosis Research Society Morbidity and Mortality Database

World Neurosurgery ◽

10.1016/j.wneu.2013.02.013 ◽

2014 ◽

Vol 81 (5-6) ◽

pp. 818-824 ◽

Cited By ~ 6

Author(s):

Brian J. Williams ◽

Justin S. Smith ◽

Dwight Saulle ◽

Christopher P. Ames ◽

Lawrence G. Lenke ◽

...

Keyword(s):

Surgical Treatment ◽

Spinal Fractures ◽

Research Society ◽

Morbidity And Mortality ◽

Scoliosis Research Society

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Morbidity and mortality associated with spinal surgery in children: a review of the Scoliosis Research Society morbidity and mortality database

Journal of Neurosurgery Pediatrics ◽

10.3171/2010.10.peds10212 ◽

2011 ◽

Vol 7 (1) ◽

pp. 37-41 ◽

Cited By ~ 48

Author(s):

Kai-Ming G. Fu ◽

Justin S. Smith ◽

David W. Polly ◽

Christopher P. Ames ◽

Sigurd H. Berven ◽

...

Keyword(s):

Spinal Surgery ◽

Perioperative Complications ◽

Research Society ◽

Morbidity And Mortality ◽

Neurological Deficits ◽

Neurophysiological Monitoring ◽

Mortality Data ◽

P Value ◽

Scoliosis Research Society ◽

Scoliosis Correction

Object Currently, few studies regarding morbidity and mortality associated with operative treatment of spinal disorders in children are available to guide the surgeon. This study provides more detailed morbidity and mortality data with an analysis of 23,918 pediatric cases reported in the multicenter, multisurgeon Scoliosis Research Society morbidity and mortality database. Methods The Scoliosis Research Society morbidity and mortality database was queried for the years from 2004 to 2007. The inclusion criterion was age 18 years or younger. Cases were categorized by operation type and diagnosis. Details on the surgical approach, use of neurophysiological monitoring, and type of instrumentation were recorded. Major perioperative complications and deaths were evaluated. Statistical analysis was performed with chi-square testing, with a p value < 0.05 considered significant. Results A total of 23,918 patients were included. The mean age was 13 ± 3.6 years (± SD). Spinal pathology included the following: scoliosis (in 19,642 patients), kyphosis (in 1455), spondylolisthesis (in 748), trauma (in 478), and other (in 1595 patients). The overall complication rate was 8.5%. Major complications included wound infections (2.7%), new neurological deficits (1.4%), implant-related complications (1.6%), and hematomas (0.4%). The most common medical complications were respiratory related (0.9%). Morbidity rates differed based on pathology, with patients undergoing treatment for kyphosis and spondylolisthesis having higher overall rates of morbidity (14.7% and 9.6%, respectively). Patients undergoing revision procedures (2034) or corrective osteotomies (2787) were more likely to suffer a complication or new neurological deficit. The majority of these deficits improved at least partially. Thirty-one deaths were reported for an overall rate of 1.3 per 1000. Respiratory complications were the most common cause of mortality (13 cases). Twenty-six of the deaths occurred in children undergoing scoliosis correction. Conclusions Spinal surgery in children is associated with a range of complications depending on the type of operation. Mortality rates for all indications and operations were low. Patients undergoing more aggressive corrective procedures for deformity are more likely to suffer complications and new neurological deficits.

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Patient Age and Vasospasm After Subarachnoid Hemorrhage

Neurosurgery ◽

10.1227/neu.0b013e3181ed11ab ◽

2010 ◽

Vol 67 (4) ◽

pp. 911-917 ◽

Cited By ~ 24

Author(s):

Mats Ryttlefors ◽

Per Enblad ◽

Elisabeth Ronne-Engström ◽

Lennart Persson ◽

Don Ilodigwe ◽

...

Keyword(s):

Subarachnoid Hemorrhage ◽

Aneurysmal Subarachnoid Hemorrhage ◽

Continuous Variable ◽

Dose Finding ◽

Neurological Deficits ◽

Patient Age ◽

Angiographic Vasospasm ◽

Patient Âgé ◽

Ruptured Intracranial Aneurysm ◽

Multiple Logistic Regression Modeling

Abstract BACKGROUND: Subarachnoid hemorrhage (SAH) from a ruptured intracranial aneurysm is a devastating disease with high mortality and morbidity. The incidence of SAH increases with advancing age. OBJECTIVE: To determine whether age is an independent predictor of angiographic vasospasm, delayed ischemic neurological deficits (DINDs), or abnormal transcranial Doppler (TCD) measurements in patients with aneurysmal subarachnoid hemorrhage. METHODS: Data from CONSCIOUS-1 (Clazosentan to Overcome Neurological Ischemia and Infarct Occurring After Subarachnoid Hemorrhage study), a dose-finding study of clazosentan, were used. Data on angiographic vasospasm, DINDs, and TCD abnormalities were prospectively recorded as well as baseline characteristics and treatment data. Patient age was considered in 3 ways: as a continuous variable, dichotomized at age 65 years, and categorized by decade. Age was investigated as the main variable, whereas other possible confounding variables were adjusted for in the multiple logistic regression modeling with each of 3 dichotomized vasospasm outcome measures, presence or absence of angiographic vasospasm, DINDs, and TCD abnormalities as the dependent variable. RESULTS: The proportions of patients with angiographic vasospasm, DINDs, and TCD abnormalities were 45%, 19%, and 81%, respectively. Age, whether considered as a continuous, dichotomous, or a categorical variable, was not significantly associated with angiographic vasospasm, DINDs, or abnormal TCD measurements. CONCLUSION: Age does not seem to be a significant predictor for cerebral vasospasm after subarachnoid hemorrhage.

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Association between patient age at the time of surgical treatment for endometriosis and aryl hydrocarbon receptor repressor polymorphism

Fertility and Sterility ◽

10.1016/j.fertnstert.2009.04.041 ◽

2009 ◽

Vol 92 (4) ◽

pp. 1240-1242 ◽

Cited By ~ 6

Author(s):

Hironori Asada ◽

Tatsuhiko Yagihashi ◽

Masataka Furuya ◽

Kenjiro Kosaki ◽

Takao Takahashi ◽

...

Keyword(s):

Surgical Treatment ◽

Aryl Hydrocarbon Receptor ◽

Patient Age ◽

Aryl Hydrocarbon ◽

Patient Âgé

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Shock Index, Pediatric Age-Adjusted Predicts Morbidity and Mortality in Children Admitted to the Intensive Care Unit

Frontiers in Pediatrics ◽

10.3389/fped.2021.727466 ◽

2021 ◽

Vol 9 ◽

Author(s):

Kuo-Chen Huang ◽

Ying Yang ◽

Chao-Jui Li ◽

Fu-Jen Cheng ◽

Ying-Hsien Huang ◽

...

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Inotropic Support ◽

Morbidity And Mortality ◽

Pediatric Age ◽

Shock Index ◽

Patient Age ◽

Early Management ◽

Icu Admission ◽

Patient Âgé

Background: The shock index, pediatric age-adjusted (SIPA), defined as the maximum normal heart rate divided by the minimum normal systolic blood pressure by age, can help predict the risk of morbidity and mortality after pediatric trauma. This study investigated whether the SIPA can be used as an early index of prognosis for non-traumatic children visiting the pediatric emergency department (ED) and were directly admitted to the intensive care unit (ICU). We hypothesized that an increase in SIPA values in the first 24 h of ICU admission would correlate with mortality and adverse outcomes.Methods: This multicenter retrospective study enrolled non-traumatic patients aged 1–17 years who presented to the pediatric ED and were directly admitted to the ICU from January 1, 2016, to December 31, 2018, in Taiwan. The SIPA value was calculated at the time of arrival at the ED and 24 h after ICU admission. Cutoffs included SIPA values >1.2 (patient age: 1–6), >1.0 (patient age: 7–12), and >0.9 (patient age: 12–17). The utility of the SIPA and the trends in the SIPA during the first 24 h of ICU admission were analyzed to predict outcomes.Results: In total, 1,732 patients were included. Of these, 1,050 (60.6%) were under 6 years old, and the median Pediatric Risk of Mortality score was 7 (5–10). In total, 4.7% of the patients died, 12.9% received mechanical ventilator (MV) support, and 11.1% received inotropic support. The SIPA value at 24 h after admission was associated with increased mortality [odds ratio (OR): 4.366, 95% confidence interval (CI): 2.392–7.969, p < 0.001], MV support (OR: 1.826, 95% CI: 1.322–2.521, p < 0.001), inotropic support (OR: 2.306, 95% CI: 1.599–3.326, p < 0.001), and a long hospital length of stay (HLOS) (2.903 days, 95% CI: 1.734–4.271, p < 0.001). Persistent abnormal SIPA value was associated with increased mortality (OR: 2.799, 95% CI: 1.566–5.001, p = 0.001), MV support (OR: 1.457, 95% CI: 1.015–2.092, p = 0.041), inotropic support (OR: 1.875, 95% CI: 1.287–2.833, p = 0.001), and a long HLOS (3.2 days, 95% CI: 1.9–4.6, p < 0.001). Patients with abnormal to normal SIPA values were associated with decreased mortality (OR: 0.258, 95% CI: 0.106–0.627, p = 0.003), while patients with normal to abnormal SIPA values were associated with increased mortality (OR: 3.055, 95% CI: 1.472–5.930, p = 0.002).Conclusions: In non-traumatic children admitted to the ICU from the ED, increased SIPA values at 24 h after ICU admission predicted high mortality and bad outcomes. Monitoring the trends in the SIPA could help with prognostication and optimize early management.

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99. Morbidity and Mortality in the Surgical Treatment of 605 Pediatric Patients with Isthmic or Dysplastic Spondylolisthesis: A Report from the Scoliosis Research Society Morbidity and Mortality Committee

The Spine Journal ◽

10.1016/j.spinee.2009.08.123 ◽

2009 ◽

Vol 9 (10) ◽

pp. 52S

Author(s):

Kai-Ming Fu ◽

Justin Smith ◽

Christopher Shaffrey ◽

Sigurd Berven ◽

Paul Broadstone ◽

...

Keyword(s):

Surgical Treatment ◽

Pediatric Patients ◽

Research Society ◽

Morbidity And Mortality ◽

Scoliosis Research Society

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Outcome of Surgical or Endovascular Treatment of Giant Intracranial Aneurysms, with Emphasis on Age, Aneurysm Location, and Unruptured Aneuryms - A Systematic Review and Meta-Analysis

Cerebrovascular Diseases ◽

10.1159/000443485 ◽

2016 ◽

Vol 41 (3-4) ◽

pp. 187-198 ◽

Cited By ~ 17

Author(s):

Julius Dengler ◽

Nicolai Maldaner ◽

Sven Gläsker ◽

Matthias Endres ◽

Martin Wagner ◽

...

Keyword(s):

Treatment Outcome ◽

Surgical Treatment ◽

Endovascular Treatment ◽

Intracranial Aneurysms ◽

Meta Analysis ◽

Separate Analysis ◽

Patient Age ◽

Good Outcome ◽

Giant Intracranial Aneurysms ◽

Patient Âgé

Background: Designing treatment strategies for unruptured giant intracranial aneurysms (GIA) is difficult as evidence of large clinical trials is lacking. We examined the outcome following surgical or endovascular GIA treatment focusing on patient age, GIA location and unruptured GIA. Methods: Medline and Embase were searched for studies reporting on GIA treatment outcome published after January 2000. We calculated the proportion of good outcome (PGO) for all included GIA and for unruptured GIA by meta-analysis using a random effects model. Results: We included 54 studies containing 64 study populations with 1,269 GIA at a median follow-up time (FU-T) of 26.4 months (95% CI 10.8-42.0). PGO was 80.9% (77.4-84.4) in the analysis of all GIA compared to 81.2% (75.3-86.1) in the separate analysis of unruptured GIA. For each year added to patient age, PGO decreased by 0.8%, both for all GIA and unruptured GIA. For all GIA, surgical treatment resulted in a PGO of 80.3% (95% CI 76.0-84.6) compared to 84.2% (78.5-89.8, p = 0.27) after endovascular treatment. In unruptured GIA, PGO was 79.7% (95% CI 71.5-87.8) after surgical treatment and 84.9% (79.1-90.7, p = 0.54) after endovascular treatment. PGO was lower in high quality studies and in studies presenting aggregate instead of individual patient data. In unruptured GIA, the OR for good treatment outcome was 5.2 (95% CI 2.0-13.0) at the internal carotid artery compared to 0.1 (0.1-0.3, p < 0.1) in the posterior circulation. Patient sex, FU-T and prevalence of ruptured GIA were not associated with PGO. Conclusions: We found that the chances of good outcome after surgical or endovascular GIA treatment mainly depend on patient age and aneurysm location rather than on the type of treatment conducted. Our analysis may inform future research on GIA.

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