Background: Surgery for cervical spondylotic myelopathy (CSM) is generally safe and effective. Nonetheless, complications occur in 11% to 38% of patients. Knowledge of important predictors of complications will help clinicians identify high-risk patients and institute prevention and management strategies.
Objective: To identify clinical and surgical predictors of perioperative complications in CSM patients.
Methods: Four hundred seventy-nine surgical CSM patients were enrolled in the prospective CSM-International study at 16 sites. A panel of physicians reviewed all adverse events and classified each as related or unrelated to surgery. Univariate analyses were performed to determine differences between patients who experienced a perioperative complication and those who did not. A complication prediction rule was developed using multiple logistic regression.
Results: Seventy-eight patients experienced 89 perioperative complications (16.25%). On univariate analysis, the major clinical risk factors were ossification of the posterior longitudinal ligament (OPLL) (P = .055), number of comorbidities (P = .002), comorbidity score (P = .006), diabetes mellitus (P = .001), and coexisting gastrointestinal (P = .039) and cardiovascular (P = .046) disorders. Patients undergoing a 2-stage surgery (P = .002) and those with a longer operative duration (P = .001) were at greater risk of perioperative complications. A final prediction model consisted of diabetes mellitus (odds ratio [OR] = 1.96, P = .060), number of comorbidities (OR = 1.20, P = .069), operative duration (OR = 1.07, P = .002), and OPLL (OR = 1.75, P = .040).
Conclusion: Surgical CSM patients have a higher risk of perioperative complications if they have a greater number of comorbidities, coexisting diabetes mellitus, OPLL, and a longer operative duration. Surgeons can use this information to discuss the risks and benefits of surgery with patients, to plan case-specific preventive strategies, and to ensure appropriate management in the perioperative period.
Abbreviations: BMI, body mass indexCSM, cervical spondylotic myelopathymJOA, modified Japanese Orthopaedic AssociationOPLL, ossification of the posterior longitudinal ligament.
Download full-text PDF |
Source |
---|---|
http://dx.doi.org/10.1227/NEU.0000000000001151 | DOI Listing |
Pediatr Cardiol
January 2025
Division of Pediatric Cardiology, Department of Cardiovascular Medicine, Mayo Clinic, 200 1st St SW, Rochester, MN, 55901, USA.
Historically, children undergoing cardiac catheterization have been managed with general endotracheal anesthesia (GETA). However, recent practice has favored general anesthesia with total intravenous anesthesia (TIVA). This study compares procedural outcomes in the pediatric cardiac catheterization laboratory (PCCL) for children undergoing low-risk cardiac catheterization with GETA vs.
View Article and Find Full Text PDFJ Am Acad Orthop Surg
January 2025
From the Department of Orthopedic Surgery, Cleveland Clinic Foundation, Cleveland, OH (Pasqualini, Ibaseta, T Khan, and Piuzzi), the Case Western Reserve University School of Medicine, Cleveland, OH (Pan, Xu, and Austin), the Department of Orthopaedic Surgery, Larkin Community Hospital, South Miami, FL (Corces), and Levitetz Department of Orthopaedic Surgery, the Cleveland Clinic Florida, Weston, FL (Higuera).
Background: Total hip arthroplasty (THA) practices are evolving under the influence of the current value-based healthcare system and bundled payment models. This study aimed to (1) evaluate national trends in discharge disposition and postoperative outcomes after THA, (2) compare discharge cohorts on episode-of-care parameters, and (3) determine predictors of nonhome discharge from 2011 to 2021.
Methods: The National Surgical Quality Improvement Program database was queried for THA data from 2011 to 2021.
Anesth Analg
February 2025
Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts.
Background: Several health care networks have fully adopted second-generation supraglottic airway (SGA) i-gel. Real-world evidence of enhanced patient safety after such practice change is lacking. We hypothesized that the implementation of i-gel compared to the previous LMA®-Unique™ would be associated with a lower risk of airway-related safety events.
View Article and Find Full Text PDFJ Patient Saf
January 2025
Department of Preventive and Social Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
Objectives: Home assessment and modification are crucial to prevent fall and fall-related injuries, especially in vulnerable subjects. This study assessed the need for home modifications and investigated risk factors associated with home injuries in post-total knee arthroplasty (TKA) patients.
Methods: This study was conducted at the university hospital from July 2022 to July 2023.
JSLS
January 2025
Department of Urology, University of Yamanashi Graduate School of Medical Sciences, Chuo, Yamanashi, Japan. (all authors).
Introduction: Retroperitoneal laparoscopic surgery for benign retroperitoneal tumors is often challenging because of variations in the tumor location and size. In this study, we present a retroperitoneal laparoscopic resection technique used at our institution to treat benign retroperitoneal tumors.
Materials And Methods: This retrospective case series included nine consecutive patients who underwent retroperitoneal laparoscopic tumor resection between 2011 and 2023.
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!