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  • Thirty-day Postoperative Complications Following Corpectomy for Intraspinal Lesions in the American College of Surgeons National Surgical Quality Improvement Program (NSQIP)

    Final Number:
    4041

    Authors:
    Andrew Rock; Matthew Carr; Charles Opalak; Kathryn Workman; William Broaddus

    Study Design:
    Other

    Subject Category:

    Meeting: Congress of Neurological Surgeons 2017 Annual Meeting - Late Breaking Science

    Introduction: Corpectomy is often required in the management of intraspinal lesions. There is limited information on the occurrence of early postoperative complications following these procedures. Our objective was to determine the prevalence and risk factors for 30-day postoperative complications following corpectomy for intraspinal lesions using the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP).

    Methods: Prospectively collected data on cases of corpectomy for intraspinal lesions (CPT codes: 63300-63308) performed by neurosurgeons within the 2005-2015 ACS-NSQIP were retrospectively reviewed. Univariate and multivariable logistic regression was used to characterize the prevalence of and risk factors for 30-day postoperative complications following corpectomy for intraspinal lesions.

    Results: A total of 184 cases of corpectomy for intraspinal lesions were identified. At least one complication occurred in 83 (45.1%) cases. The three most common complications were: transfusion (29.9%), reoperation (13.6%), and sepsis (6.0%). Multivariable logistic regression analysis recognized five independent risk factors for at least one complication. These included: thoracic level (Odds Ratio [OR]: 2.80; 95% Confidence Interval [CI]: 1.09-7.19; p=0.03), lumbar/sacral level (OR: 3.68; 95% CI: 1.26-10.73; p=0.02), dyspnea (OR: 8.60; 95% CI: 1.46-50.80; p=0.02), emergency surgery (OR: 5.02; 95% CI: 1.14-22.08; p=0.03), and longer duration of surgery (OR: 1.48; 95% CI: 1.24-1.77; p<0.001).

    Conclusions: The overall prevalence of 30-day postoperative complications following corpectomy for intraspinal lesions is very high (45.1%), and most commonly due to transfusion within 72 hours of surgery (29.9%). Factors associated with postoperative complications included spinal level (thoracic, lumbar/sacral), history of dyspnea, emergency surgery, and longer duration of surgery. These risk factors have not been previously identified for this patient population and require further investigation within larger samples of patients undergoing corpectomy for intraspinal lesions.

    Patient Care: This study demonstrates a very high prevalence of at least one complication (45.1%) following corpectomy for intraspinal lesions. These complications were most commonly due to transfusion within 72 hours of surgery (29.9%) and reoperation (13.6%). Our research identified spinal level (thoracic, lumbar/sacral), history of dyspnea, emergency surgery, and longer duration of surgery as independent risk factors for postoperative complications. This information can be used by neurosurgeons to optimize the timing and medical management of patients prior to pursuing corpectomy for intraspinal lesions.

    Learning Objectives: At the conclusion of this session, participants should be able to: 1) describe demographic, comorbid, and perioperative characteristics of patients undergoing corpectomy for intraspinal lesions; 2) estimate the prevalence of postoperative complications following corpectomy for intraspinal lesions; and 3) identify risk factors for postoperative complications in corpectomy for intraspinal lesions.

    References:

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