Introduction: Previous studies have shown increased surgical times correlating with postoperative complications. However, there is no literature on the relationship between anesthesia duration and postoperative complications in adult spinal deformity surgery.
Methods: Adult patients (> 18 years) undergoing spinal deformity surgery from 2005-2012 were identified by the Current Procedural Terminology (CPT) codes in the ACS NSQIP database. Patients were subdivided into quintiles of anesthesia time. Univariate and multivariate analyses were performed to assess the impact of anesthesia duration on 30-day postoperative complications.
Results: 4,660 patients undergoing spinal deformity surgery were identified. Mean anesthesia duration for all patients was 294.7 +/- 156.5 minutes. 1,123 (24.1%) had a postoperative complication. In univariate analysis, as anaesthesia duration increased, there was a statistically significant increase in overall complications, surgical complications (superficial wound infections, wound dehiscence), medical complications (cardiac complication, pulmonary complication, deep venous thrombosis/pulmonary embolism, and sepsis), and return to the operating room within 30 days. In multivariate analyses, some trends lost their significance, but patients in the two highest groups of anesthesia duration (295-405 minutes and 405-1080 minutes) had increased risk of overall medical complications and return to the operating room.
Conclusions: Patients in the two highest groups of anesthesia duration (295 minutes-405 minutes and 405-1080 minutes) had increased postoperative medical complications and return to the operating room within 30 days, but did not have an increased risk of certain surgical complications. This is the largest study to date to investigate the topic of longer anesthesia times imparting greater risk to adults undergoing spinal deformity surgery.
Patient Care: This is the largest study to date to investigate the topic of longer anesthesia times imparting greater risk to adults undergoing spinal deformity surgery. Patient care can be improved with this information.
Learning Objectives: By the conclusion of this session, participants should be able to analyze whether duration of anesthesia influences complication rates in patients undergoing adult deformity spine surgery.