Dataset Information

Risk factors for medical complication after lumbar spine surgery: a multivariate analysis of 767 patients.

ABSTRACT:

Study design

Multivariate analysis of prospectively collected registry data.

Objective

Using multivariate analysis to determine significant risk factors for medical complication after lumbar spine surgery.

Summary of background data

Several studies have examined the occurrence of medical complication after spine surgery. However, many of these studies have been done utilizing large national databases. Although these allow for analysis of thousands of patients, potentially influential covariates are not accounted for in these retrospective studies. Furthermore, the accuracy of these retrospective data collection in these databases has been called into question.

Methods

The Spine End Results Registry (2003–2004) is a collection of prospectively collected data on all patients who underwent spine surgery at our two institutions. Extensive demographic and medical information were prospectively recorded as described previously by Mirza et al. Complications were defined in detail a priori and were prospectively recorded for at least 2 years after surgery. We analyzed risk factors for medical complication after lumbar spine surgery using univariate and multivariate analysis.

Results

We analyzed data from 767 patients who met out inclusion criteria. The cumulative incidences of complication after lumbar spine surgery per organ system are as follows: cardiac, 13%; pulmonary, 7%; gastrointestinal, 6.7%; neurological, 8.2%; hematological, 17.5%; and urologic complications, 10.3%. The occurrence of cardiac or respiratory complication after lumbar spine surgery was significantly associated with death within 2 years (relative risk: 6.09 and 10.9, respectively). Several significant risk factors were identified for organ-specific complications. Among these, surgical invasiveness appeared to be the largest risk factor for cardiac, pulmonary, neurological, and hematological complications.

Conclusion

Risk factors identified in this study can be beneficial to clinicians and patients alike when considering surgical treatment of the lumbar spine. Future analyses and models that predict the occurrence of medical complication after lumbar spine surgery may be of further benefit for surgical decision making.

SUBMITTER: Lee MJ

PROVIDER: S-EPMC3711415 | biostudies-literature | 2011 Oct

REPOSITORIES: biostudies-literature

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Publications

Risk factors for medical complication after lumbar spine surgery: a multivariate analysis of 767 patients.

Lee Michael J MJ Hacquebord Jacques J Varshney Anuj A Cizik Amy M AM Bransford Richard J RJ Bellabarba Carlo C Konodi Mark A MA Chapman Jens J

Spine 20111001 21

<h4>Study design</h4>Multivariate analysis of prospectively collected registry data.<h4>Objective</h4>Using multivariate analysis to determine significant risk factors for medical complication after lumbar spine surgery.<h4>Summary of background data</h4>Several studies have examined the occurrence of medical complication after spine surgery. However, many of these studies have been done utilizing large national databases. Although these allow for analysis of thousands of patients, potentially i ...[more]

PMID: 22046614

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Project description:BackgroundThe purpose of this study was to investigate the longitudinal postoperative relationship between physical activity, psychosocial factors, and physical function in patients undergoing lumbar spine surgery.MethodsWe enrolled 248 participants undergoing surgery for a degenerative lumbar spine condition. Physical activity was measured using a triaxial accelerometer (Actigraph GT3X) at 6-weeks (6wk), 6-months (6M), 12-months (12M) and 24-months (24M) following spine surgery. Physical function (computerized adaptive test domain version of Patient-Reported Outcomes Measurement Information System) and psychosocial factors (pain self-efficacy, depression and fear of movement) were assessed at preoperative visit and 6wk, 6M, 12M and 24M after surgery. Structural equation modeling (SEM) techniques were utilized to analyze data, and results are represented as standardized regression weights (SRW). Overall SRW were computed across five imputed datasets to account for missing data. The mediation effect of each psychosocial factor on the effect of physical activity on physical function were computed [(SRW for effect of activity on psychosocial factor X SRW for effect of psychosocial factor on function) ÷ SRW for effect of activity on function]. Each SEM model was tested for model fit by assessing established fit indexes.ResultsThe overall effect of steps per day on physical function (SRW ranged from 0.08 to 0.19, p<0.05) was stronger compared to the overall effect of physical function on steps per day (SRW ranged from non-existent to 0.14, p<0.01 to 0.3). The effect of steps per day on physical function and function on steps per day remained consistent after accounting for psychosocial factors in each of the mediation models. Depression and fear of movement at 6M mediated 3.4% and 5.4% of the effect of steps per day at 6wk on physical function at 12M, respectively. Pain self-efficacy was not a statistically significant mediator.ConclusionsThe findings of this study suggest that the relationship between physical activity and physical function is stronger than the relationship of function to activity. However, future research is needed to examine whether promoting physical activity during the early postoperative period may result in improvement of long-term physical function. Since depression and fear of movement had a very small mediating effect, additional work is needed to investigate other potential mediating factors such as pain catastrophizing, resilience and exercise self-efficacy.

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Dataset Information

Risk factors for medical complication after lumbar spine surgery: a multivariate analysis of 767 patients.

Study design

Objective

Summary of background data

Methods

Results

Conclusion

Publications

Risk factors for medical complication after lumbar spine surgery: a multivariate analysis of 767 patients.

Similar Datasets

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