Risk Factors for Non-Neurological Complications in Adult Spinal Deformity Surgery: An International, Large-Scale, Prospective Multicenter Study
Notice bibliographique
Résumé
Introduction High risk of complications has been noted in patients with complex adult spine deformity surgery. Although the overall complication rates had been reported, they are variable and can range from 14 to 46%. However, these studies were retrospective cohorts without a clear definition of inclusion criteria and systematic collection of clinical data. As such, a complete risk profile and an accurate complication rate remain unclear. The objectives of this study were to establish the prevalence and risk factors for non-neurological complications within first 6 months of surgery. Methods This is the first prospective, multicenter study involving 15 sites from North America, Europe, and Asia. Adult patients with severe spinal deformity were followed for 6 months postoperatively. Demographic characteristics, comorbidities, functional scores, and radiographic measurements were used to determine the risk factors using multivariate modeling. Results A total of 269 patients (68% women and 32% men) were recruited (mean age: 57.8 years). Overall, 163 patients (60.6%) reported at least one incidence of complication. The prevalence of intraoperative event and postoperative complications were 29.4 ( n = 79) and 49.8% ( n = 134), respectively. Fifty-eight patients (21.6%) had major complications and 112 (42%) experienced minor complications. Moreover, 37% of the patients reported multiple complications. A total of 91 intraoperative events were reported. Dural tear was the most common intraoperative complication, accounting for 53% of all reported events. Previous spine surgery (adjusted OR: 3.6; 95% CI: 1.8–7.2) was found to be associated with intraoperative events in multivariate risk analysis. For major postoperative complications, a total of 79 cases were reported. Of these, 32% of the cases were respiratory complications, followed by loss of correction and implant failure, which accounted for 25% of the cases. Diabetes (OR: 3.8; 95% CI: 1.3–10.8) and lung disease (OR: 3.1; 95% CI: 1.0–9.4) were significant risk factors for major complications. There were a total of 206 incidences of minor postoperative complications. Fifteen percent of the cases were urinary tract infections. Twenty-five patients (9.2%) also reported new onset or worsening back or lower extremity pain after surgery, accounting for 12% of all minor complications. Previous spine surgery was the most significant risk factor for minor complications (OR: 3.0; 95% CI: 1.5–6.3). Other significant contributors included age (OR: 1.03), female gender (OR: 2.7), and duration of surgery (OR: 0.99) ( p < 0.05). Conclusion To the best of our knowledge, this is the first and largest prospective study in the world to systematically address non-neurological complications of spine deformity surgery in adults. Our findings contribute to a complete “risk profile” of such patients.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,002 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,001 |
| Bibliométrie | 0,001 | 0,002 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,000 | 0,001 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».