RT Journal Article
SR Electronic
T1 Adverse Events Following Posterior Lumbar Fusion: A Comparison of Spine Surgeons Perceptions and Reported Data for Rates and Risk Factors
JF International Journal of Spine Surgery
JO Int J Spine Surg
FD International Society for the Advancement of Spine Surgery
SP 603
OP 610
DO 10.14444/5074
VO 12
IS 5
A1 NATHANIEL T. ONDECK
A1 DANIEL D. BOHL
A1 PATAWUT BOVONRATWET
A1 RYAN P. MCLYNN
A1 JONATHAN J. CUI
A1 ANDRE M. SAMUEL
A1 MATTHEW L. WEBB
A1 JONATHAN N. GRAUER
YR 2018
UL http://ijssurgery.com//content/12/5/603.abstract
AB Background: Postoperative complications and risks factors for adverse events play an important role in both decision making and patient expectation setting. The present study serves to contrast surgeons' perceived and reported rates of postoperative adverse events following posterior lumbar fusion (PLF) and to assess the accuracy of predicting the impact of patient factors on such outcomes.Methods: A survey investigating perceived rates of adverse events and the impact of patient risk factors on them following PLF for degenerative conditions was distributed to spine surgeons at the Lumbar Spine Research Society (LSRS) 2016 annual meeting. For comparison, the corresponding rates and patient risk factors were assessed in patients undergoing elective PLF from the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) data years 2011–2014.Results: From the survey, there were 53 responses (response rate of 79%) from attending physicians at LSRS. From NSQIP, there were 16,589 patients who met the inclusion criteria. Adverse event rates estimated by the surgeons at LSRS were close to those determined by NSQIP data (no greater than 2.81% different). The largest differences were for deep vein thrombosis (overestimation of 2.81%, P < .001), anemia requiring transfusion (overestimation of 2.47%, P = .018), and urinary tract infection (overestimation of 2.29%, P < .001). Similarly, the estimated impact of patient factors was similar to the data (within relative risk of 2.02). The largest differences were for current smoking (overestimation of 2.02 relative risk, P < .001), insulin dependent diabetes (overestimation of 1.36, P < .001), and obesity (overestimation of 1.35, P < .001).Conclusions: The current study noted that surgeon estimates were relatively close to national numbers for estimating the adverse events and impact of patient factors on such outcomes after PLF for degenerative conditions. The estimates are roughly appropriate with a bias toward overestimation for planning and expectation setting.