Factors and Predictive Model Associated With Perioperative Complications After Long Fusion in the Treatment of Adult Non-Degenerative Scoliosis
Introduction
Adult non-degenerative scoliosis accounts for 90% of spinal deformities in young adults. However, perioperative complications and related risk factors of long posterior instrumentation and fusion for the treatment of adult non-degenerative scoliosis have not been adequately studied.
Methods
We evaluated clinical and radiographical results from 180 patients with adult non-degenerative scoliosis who underwent long posterior instrumentation and fusion. Preoperative clinical data, intraoperative variables, and perioperative radiographic parameters were collected to analyze the risk factors for perioperative complications. Potential and independent risk factors for perioperative complications were evaluated by univariate analysis and logistic regression analysis.
Results
180 adult non-degenerative scoliosis patients were included in our study. There were 31 perioperative complications for 25 (13.9%) patients, 11 of which were cardiopulmonary-related complications, five of which were infection, six of which were neurological-related complications, three of which were gastrointestinal-related complications, and six of which were incision-related problems. The independent risk factors for development of perioperative complications included change in Cobb angle (odds ratio [OR]=1.058, 95% CI=1.011~1.108, P=0.015), change in central vertical axis (CVA) (OR=1.066, 95% CI=1.019-1.116, P=0.006) and red blood cell (RBC) transfusion (OR=5.631, 95% CI=1.676~18.924, P=0.005). The area under the receiver operating characteristic (ROC) curve based on predicted probability of the logistic regression was 0.746.
Conclusions
Blood transfusion, Cobb change, and CVA change were independent risk factors for perioperative complications after long-segment posterior instrumentation and fusion in adult non-degenerative scoliosis patients.
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Posted 16 Dec, 2020
On 01 Jan, 2021
Received 21 Dec, 2020
Received 21 Dec, 2020
Received 21 Dec, 2020
Received 21 Dec, 2020
On 19 Dec, 2020
On 19 Dec, 2020
On 19 Dec, 2020
On 19 Dec, 2020
On 19 Dec, 2020
On 19 Dec, 2020
On 19 Dec, 2020
Invitations sent on 16 Dec, 2020
On 16 Dec, 2020
On 14 Dec, 2020
On 14 Dec, 2020
On 03 Dec, 2020
Factors and Predictive Model Associated With Perioperative Complications After Long Fusion in the Treatment of Adult Non-Degenerative Scoliosis
Posted 16 Dec, 2020
On 01 Jan, 2021
Received 21 Dec, 2020
Received 21 Dec, 2020
Received 21 Dec, 2020
Received 21 Dec, 2020
On 19 Dec, 2020
On 19 Dec, 2020
On 19 Dec, 2020
On 19 Dec, 2020
On 19 Dec, 2020
On 19 Dec, 2020
On 19 Dec, 2020
Invitations sent on 16 Dec, 2020
On 16 Dec, 2020
On 14 Dec, 2020
On 14 Dec, 2020
On 03 Dec, 2020
Introduction
Adult non-degenerative scoliosis accounts for 90% of spinal deformities in young adults. However, perioperative complications and related risk factors of long posterior instrumentation and fusion for the treatment of adult non-degenerative scoliosis have not been adequately studied.
Methods
We evaluated clinical and radiographical results from 180 patients with adult non-degenerative scoliosis who underwent long posterior instrumentation and fusion. Preoperative clinical data, intraoperative variables, and perioperative radiographic parameters were collected to analyze the risk factors for perioperative complications. Potential and independent risk factors for perioperative complications were evaluated by univariate analysis and logistic regression analysis.
Results
180 adult non-degenerative scoliosis patients were included in our study. There were 31 perioperative complications for 25 (13.9%) patients, 11 of which were cardiopulmonary-related complications, five of which were infection, six of which were neurological-related complications, three of which were gastrointestinal-related complications, and six of which were incision-related problems. The independent risk factors for development of perioperative complications included change in Cobb angle (odds ratio [OR]=1.058, 95% CI=1.011~1.108, P=0.015), change in central vertical axis (CVA) (OR=1.066, 95% CI=1.019-1.116, P=0.006) and red blood cell (RBC) transfusion (OR=5.631, 95% CI=1.676~18.924, P=0.005). The area under the receiver operating characteristic (ROC) curve based on predicted probability of the logistic regression was 0.746.
Conclusions
Blood transfusion, Cobb change, and CVA change were independent risk factors for perioperative complications after long-segment posterior instrumentation and fusion in adult non-degenerative scoliosis patients.
Figure 1
Figure 2