Global Spine J
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 (
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.
Neurosciences (Brain & Spine)
Klineberg, Eric O; Passias, Peter G; Poorman, Gregory W; Jalai, Cyrus M; Atanda, Abiola; Worley, Nancy; Horn, Samantha; Sciubba, Daniel M; Hamilton, D Kojo; Burton, Douglas C; Gupta, Munish Chandra; Smith, Justin S; Soroceanu, Alexandra; Hart, Robert A; Neuman, Brian; Ames, Christopher P; Schwab, Frank J; and Lafage, Virginie, "Classifying Complications: Assessing Adult Spinal Deformity 2-Year Surgical Outcomes." (2020). Articles, Abstracts, and Reports. 3549.