当前位置： SCI文献检索 > SPINE期刊下所有文献 > Surgeon specialty and outcomes after elective spine surgery.

Surgeon specialty and outcomes after elective spine surgery.

Abstract：

STUDY DESIGN:Retrospective cohort analysis of prospectively collected clinical data. OBJECTIVE:To compare outcomes of elective spine fusion and laminectomy when performed by neurological and orthopedic surgeons. SUMMARY OF BACKGROUND DATA:The relationship between primary specialty training and outcome of spinal surgery is unknown. METHODS:We analyzed the 2006 to 2012 American College of Surgeons National Surgical Quality Improvement Project database of 50,361 patients, 33,235 (66%) of which were operated on by a neurosurgeon. We eliminated all differences in preoperative and intraoperative risk factors between surgical specialties by matching 17,126 patients who underwent orthopedic surgery (OS) to 17,126 patients who underwent neurosurgery (NS) on propensity scores. Regular and conditional logistic regressions were used to predict adverse postoperative outcomes in the full sample and matched sample, respectively. The effect of perioperative transfusion on outcomes was further assessed in the matched sample. RESULTS:Diagnosis and procedure were the only factors that were found to be significantly different between surgical subspecialties in the full sample. We found that compared with patients who underwent NS, patients who underwent OS were more than twice as likely to experience prolonged length of stay (LOS) (odds ratio: 2.6, 95% confidence interval: 2.4-2.8), and significantly more likely to receive a transfusion perioperatively, have complications, and to require discharge with continued care. After matching, patients who underwent OS continued to have slightly higher odds for prolonged LOS, and twice the odds for receiving perioperative transfusion compared with patients who underwent NS. Taking into account perioperative transfusion did not eliminate the difference in LOS between patients who underwent OS and those who underwent NS. CONCLUSION:Patients operated on by OS have twice the odds for undergoing perioperative transfusion and slightly increased odds for prolonged LOS. Other differences between surgical specialties in 30-day postoperative outcomes were minimal. Analysis of a large, multi-institutional sample of prospectively collected clinical data suggests that surgeon specialty has limited influence on short-term outcomes after elective spine surgery. LEVEL OF EVIDENCE:3.

journal_name

Spine (Phila Pa 1976)

journal_title

Spine

authors

Seicean A,Alan N,Seicean S,Neuhauser D,Benzel EC,Weil RJ

doi

10.1097/BRS.0000000000000489

subject

Has Abstract

pub_date

2014-09-01 00:00:00

pages

1605-13

issue

eissn

0362-2436

issn

1528-1159

journal_volume

pub_type

杂志文章

在线工具

Surgeon specialty and outcomes after elective spine surgery.