Morbidity and mortality following degenerative spine surgery in a prospective cohort of 1687 consecutive surgical proced
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ORIGINAL ARTICLE - SPINE DEGENERATIVE
Morbidity and mortality following degenerative spine surgery in a prospective cohort of 1687 consecutive surgical procedures Stian Solumsmoen 1,2 & Tanvir Johanning Bari 3 & Sara Woldu 1 & Oliver Bremerskov Zielinski 1 & Martin Gehrchen 3,4 & Benny Dahl 5 & Rachid Bech-Azeddine 1,4 Received: 14 September 2020 / Accepted: 16 November 2020 # Springer-Verlag GmbH Austria, part of Springer Nature 2020
Abstract Study design Prospective, observational cohort study. Objective To determine the true incidence of adverse events (AEs) in European adults undergoing surgery for degenerative spine diseases. Summary of background data The majority of surgeries performed for degenerative spinal diseases are elective, and the need for adequate estimation of risk-benefit of the intended surgery is imperative. A cumbersome obstacle for adequate estimation of surgery-related risks is that the true incidence of complications or adverse events (AEs) remains unclear. Methods All adult patients (≥ 18 years) undergoing spine surgery at a single center from February 1, 2016, to January 31, 2017, were prospectively and consecutively included. Morbidity and mortality were determined using the Spine AdVerse Events Severity (SAVES) system. Additionally, the correlation between the AEs and length of stay (LOS) and mortality was assessed. Results A total of 1687 procedures were performed in the study period, and all were included for analysis. Of these, 1399 (83%) were lumbar procedures and 288 (17%) were cervical. The overall incidence of AEs was 47.4%, with a minor AE incidence of 43.2% and a major of 14.5%. Female sex (OR 1.5 [95% CI 1.2–1.9), p < 0.001) and age > 65 years (OR 1.5 [95% CI 1.1–1.7], p = 0.012) were significantly associated with increased odds of having an AE. Conclusion Based on prospectively registered AEs in this single-center study, we validated the use of the SAVES system in a European population undergoing spine surgery due to degenerative spine disease. We found a higher incidence of AEs than previously reported in retrospective studies. The major AEs registered occurred significantly more often perioperatively and in patients > 65 years. Keywords Degenerative spine surgery . Complications . Adverse events . Prospective
This article is part of the Topical Collection on Spine degenerative * Stian Solumsmoen [email protected] 1
Copenhagen Spine Research Unit (CSRU), Section of Spine Surgery, Center of Rheumatology and Spine Diseases, Rigshospitalet-Glostrup, Valdemar Hansens vej 17, 2600 Glostrup, Denmark
2
Department of Epidemiology Research, Statens Serum Institut, 2300 Copenhagen, Artillerivej 5, Denmark
3
Spine Unit, Department of Orthopedic Surgery, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, 2100 Copenhagen, Denmark
4
Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
5
Department of Orthopedics and Scoliosis Surgery, Texas Children’s Hospital and Baylor College of Medicine, 6621 Fannin St, Houston, TX 77
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