Abstract:
BACKGROUND:Readmission and reoperation are used as hospital and surgeon quality metrics. Venous thromboembolic (VTE) events, including deep vein thrombosis and pulmonary embolism (PE), are a major cause of readmission, morbidity, and mortality after spine surgery. Specific procedural, perioperative, and patient characteristics may be associated with these outcomes. METHODS:We retrospectively examined records from 6869 consecutive spine surgeries at our institution. We collected data on patient demographics, surgery, hospital course, and 30-day rates of VTE, readmission, reoperation, and epidural hematoma. Stepwise multivariable logistic regression was used to identify independent predictors of each outcome. RESULTS:Factors associated with VTE within 30 days of surgery include a history of VTE (odds ratio [OR] 3.92 [confidence interval 1.83-8.36], P < 0.001), estimated blood loss (EBL; OR 1.017 [1.005-1.029], P = 0.004), fracture (OR 5.42 [2.09-14.05], P = 0.001), history of PE (OR 4.04 [1.22-13.42], P = 0.023), and transfusion (OR 2.26 [1.07-4.77], P = 0.033). Factors associated with readmission were a history of PE (OR 3.27 [1.07-9.97], P = 0.038), PE (OR 8.07 [2.26-28.8], P = 0.001), transfusion (OR 2.54 [1.55-4.17], P < 0.001), comorbid disease burden (OR 1.35 [1.01-1.80], P = 0.041), and tumor surgery (OR 2.84 [1.32-6.10], P = 0.007). Factors associated with reoperation were EBL (OR 1.024 [1.006-1.042], P = 0.008), transfusion (OR 3.86 [1.38-10.79], P = 0.01), and PE (OR 6.05 [1.03-35.62], P = 0.046). Transfusion was associated with epidural hematoma within 30 days (OR 7.38 [1.37-39.83], P = 0.02). CONCLUSIONS:Transfusion and EBL are associated with numerous negative outcomes. Transfusion is an independent predictor of VTE, readmission, reoperation, and epidural hematoma requiring evacuation. Specific pathologies were associated with specific negative outcomes.
journal_name
World Neurosurgjournal_title
World neurosurgeryauthors
Cloney M,Dhillon ES,Roberts H,Smith ZA,Koski TR,Dahdaleh NSdoi
10.1016/j.wneu.2017.11.168subject
Has Abstractpub_date
2018-03-01 00:00:00pages
e91-e97eissn
1878-8750issn
1878-8769pii
S1878-8750(17)32101-0journal_volume
111pub_type
杂志文章abstract:BACKGROUND:Atraumatic acute subdural hematoma (ASDH) associated with moyamoya disease (MMD) is rare, and only a few studies have reported the bleeding origin. We present a case of atraumatic ASDH attributable to a transdural anastomosis that developed owing to the compensatory mechanisms involved in the pathogenesis of...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2018.06.197
更新日期:2018-10-01 00:00:00
abstract:BACKGROUND:Os odontoideum is a smooth, independent ossicle separated from a hypoplastic odontoid process located cranially in the expected position of the odontoid tip. The pathogenesis of os odontoideum remains controversial, and several etiological theories have been suggested for congenital, developmental, and traum...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2019.07.019
更新日期:2019-10-01 00:00:00
abstract:BACKGROUND:The biopsy is recognized as the most accurate method to determine the histologic characterization of sellar germ cell tumors. It is difficult to evaluate the prognosis before histologic confirmation. OBJECTIVE:This study aimed to evaluate the independent prognostic risk factors of patients with sellar germ ...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2018.01.028
更新日期:2018-04-01 00:00:00
abstract:BACKGROUND:Plaque characteristics play pivotal roles in ischemic events, but stenosis severity does not accurately reflect carotid plaque volume due to expansive remodeling in some patients with low-grade stenosis (LGS). This study aimed to assess the safety, efficacy, and durability of carotid endarterectomy (CEA) for...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2018.11.208
更新日期:2019-03-01 00:00:00
abstract:BACKGROUND:Seizure is the second-most common presentation in patients with arteriovenous malformations (AVMs) and superimposes a significant burden on pediatric patients. Postoperative seizure risk in unruptured AVMs is underreported in the pediatric AVM literature. We aimed to characterize and identify predictive fact...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2017.05.031
更新日期:2017-09-01 00:00:00
abstract:BACKGROUND:Syringomyelia due to intracranial hypotension is rarely described. As a consequence, intracranial hypotension is less recognized as a potential cause of syringomyelia or mistaken with Chiari type 1 malformation. The pathogeny is poorly understood, and we lack diagnostic and therapeutic strategies for this pa...
journal_title:World neurosurgery
pub_type: 杂志文章,评审
doi:10.1016/j.wneu.2016.04.062
更新日期:2016-07-01 00:00:00
abstract:BACKGROUND:Traumatic spinal cord injury (SCI) guidelines recommend to maintain mean arterial pressures (MAPs) above 85 mm Hg for 7 days following SCI to minimize spinal cord ischemia. Some physicians doubt that patients with initially complete injuries benefit. OBJECTIVE:To assess the relationship between MAP augmenta...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2016.08.053
更新日期:2016-12-01 00:00:00
abstract:OBJECTIVE:To retrospectively evaluate influence of intraoperative positioning (semisitting vs. lateral decubitus) and surgeon's learning curve with regard to functional outcome of patients with vestibular schwannoma. METHODS:This study included 544 patients (median age 57 years) and spanned 3 decades: 1991-1999 (n = 1...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2020.12.107
更新日期:2020-12-28 00:00:00
abstract:BACKGROUND:A standard post-concomitant radiochemotherapy involving adjuvant temozolomide (TMZ) was stopped after 6 cycles for high-grade gliomas (HGG). Several studies demonstrated that prolonged TMZ treatment increased survival for these patients. METHODS:This retrospective study aimed to compare changes in tumor vol...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2018.03.078
更新日期:2018-06-01 00:00:00
abstract:BACKGROUND:Alveolar soft part sarcoma (ASPS) is a rare, malignant soft-tissue neoplasm typically seen in young adults that possesses an unusual tendency to metastasize. Metastases to the intramedullary compartment of the spinal cord, however, are exceptionally rare and have not been described in the literature. CASE D...
journal_title:World neurosurgery
pub_type: 杂志文章,评审
doi:10.1016/j.wneu.2017.04.100
更新日期:2017-07-01 00:00:00
abstract:OBJECTIVE:This study looks at the various comorbidities and postoperative complications and their impact on readmission rates of patients undergoing outpatient versus inpatient 1- and 2-level anterior cervical discectomy and fusion (ACDF). With increasing costs within the United States medical system, one emerging cost...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2019.03.124
更新日期:2019-06-01 00:00:00
abstract:BACKGROUND:In clipping surgery, it can be advantageous to dissect an adherent artery from the aneurysmal dome to achieve complete clipping. Bypass surgery can be useful to reconstruct an adherent artery when dissection of the artery is technically difficult or risky. We report the effectiveness of tailor-made intracran...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2019.04.074
更新日期:2019-07-01 00:00:00
abstract:OBJECTIVE:Several surgical treatment modalities, including lumboperitoneal or ventriculoperitoneal shunt surgery, subtemporal decompression, endovascular venous sinus stenting, optic nerve decompression (OND), were used in the management of idiopathic intracranial hypertension (IIH). Each surgical technique has differe...
journal_title:World neurosurgery
pub_type: 临床试验,杂志文章
doi:10.1016/j.wneu.2014.03.045
更新日期:2014-11-01 00:00:00
abstract:BACKGROUND:Brain metastases from endometrial cancer are rare and poorly described. We aimed to estimate the proportion of brain metastases at our institution that arose from endometrial cancer, and to detail clinicopathologic features and survival outcomes. METHODS:We retrospectively identified and reviewed the charts...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2020.11.087
更新日期:2020-12-13 00:00:00
abstract:OBJECTIVE:Little is known about the effectiveness of lumbar drainage (LD) in the treatment of delayed or recurrent cerebrospinal fluid (CSF) leaks. We report our institutional experience and the effectiveness of LD in the management of delayed or recurrent CSF leaks. METHODS:Between January 2014 and December 2018, a t...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2019.06.054
更新日期:2019-09-01 00:00:00
abstract:BACKGROUND:Endodermal cysts of the oculomotor nerve are rare presentations. Only case reports are available to help guide clinicians with managing this rare entity. CASE DESCRIPTION:A 3-year-old boy presented with an acute on chronic left oculomotor nerve palsy due to a left interpeduncular cistern cyst found on magne...
journal_title:World neurosurgery
pub_type:
doi:10.1016/j.wneu.2020.05.038
更新日期:2020-08-01 00:00:00
abstract:OBJECTIVE:We sought to assess the validity of a virtual surgical training system on lumbar pedicle screw placement for residents. METHODS:Ten inexperienced residents were randomly assigned to the simulation training (ST) group (n = 5) and control group (n = 5). The ST group performed the lumbar pedicle screw placement...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2017.12.015
更新日期:2018-03-01 00:00:00
abstract:BACKGROUND:Surgical treatment of patients with atlantoaxial instability caused by pathologic changes of the skull base and craniovertebral junction combined with anterior compression of the brain stem is still associated with substantial technical difficulties and remains a matter of debate. Currently, anterior stabili...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2017.09.124
更新日期:2018-01-01 00:00:00
abstract:BACKGROUND:Only a few cases of spinal cord compression after cervical laminectomy have been reported. CASE DESCRIPTION:We report a case of tetraparesis after executing a C3-C6 anterior and posterior decompression and fusion. Cervical magnetic resonance imaging demonstrated a spinal cord compression due to the impingem...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2019.08.098
更新日期:2019-12-01 00:00:00
abstract:OBJECTIVE:To explore the superior frontal sulcus (SFS) morphology, trajectory of the applied surgical corridor, and white matter bundles that are traversed during the superior frontal transsulcal transventricular approach. METHODS:Twenty normal, adult, formalin-fixed cerebral hemispheres and 2 cadaveric heads were inc...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2017.06.161
更新日期:2017-10-01 00:00:00
abstract:INTRODUCTION:Several methods have been proposed to achieve a watertight dural closure, including the use of fibrin sealant to reinforce sutures. We propose a fast technique using oxidized cellulose and fibrin glue to achieve firm and watertight closure of minor dural defects in supratentorial cranial surgery. TECHNICA...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2010.09.029
更新日期:2011-07-01 00:00:00
abstract:OBJECTIVE:Shunt overdrainage is a potential complication in pediatric hydrocephalus. The addition of adjustable gravitational units to previous shunt systems has been proposed as effective management for this problem. These devices have been traditionally implanted over the occipital bone. We propose chest implantation...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2020.11.001
更新日期:2020-11-07 00:00:00
abstract:OBJECTIVE:We aimed to evaluate the combined effect of ellagic acid (EA) and temozolomide (TEM) on the cadherin switch and angiogenesis in the C6 glioma cell line. METHODS:A total of 100 μM EA and 100 μM TEM were applied to rat C6 glioma cells for 24, 48, and 72 hours. Cell proliferation was detected by 5-bromo-2'-deox...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2019.08.228
更新日期:2019-12-01 00:00:00
abstract:OBJECTIVES:Although a number of studies have implicated ischemia and hypoxia in the pathogenesis of cervical spondylosis, quantification remains difficult and the role of ischemia and hypoxia on disease progression and disease severity in human cervical spondylosis remains largely unknown. Therefore, the objective of t...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2019.04.253
更新日期:2019-08-01 00:00:00
abstract:OBJECTIVE:Carotid artery ligation (CAL) is used to treat large and complex intracranial aneurysms. However, little is known about long-term survival and causes of death in patients who undergo the procedure. This study was intended to evaluate if patients who have undergone CAL have long-term excess mortality and what ...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2016.01.023
更新日期:2016-06-01 00:00:00
abstract:OBJECTIVE:To review retrospectively experience with stent-assisted coiling of ophthalmic segment internal carotid artery (ICA) aneurysms to report outcome data and identify the rate of associated visual complications. METHODS:The Duke endovascular database was retrospectively reviewed to identify all ICA aneurysms tre...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2011.12.003
更新日期:2012-09-01 00:00:00
abstract:BACKGROUND:Cranial defects following anterior cranial base surgery have been frequently reconstructed using the pericranial flap. METHODS:We present a simple technique for preparing the flap using injection of saline into the subgaleal space. RESULTS:We inserted a 20-gauge needle perpendicular to 8-10 spots in the fr...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2016.12.019
更新日期:2017-03-01 00:00:00
abstract:OBJECTIVE:Because of the balance between achieving complete seizure freedom and minimizing the postoperative neurologic deficits, surgery for refractory epilepsy originating from the primary motor cortex is difficult. Here, we report the outcomes of surgery for magnetic resonance imaging-negative refractory epilepsy or...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2017.02.090
更新日期:2017-06-01 00:00:00
abstract:BACKGROUND:Successful resection of arteriovenous malformation (AVM) depends on preoperative assessment of the detailed morphology of the AVM. Simultaneous detailed three-dimensional visualization of the feeding arteries, draining veins, and surrounding structures is needed. The aim of this study was to evaluate the use...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2018.12.217
更新日期:2019-01-22 00:00:00
abstract:BACKGROUND:Traumatic cervical pseudomeningoceles (TCPs) occur secondary to traction of the cervical nerve roots resulting in violation of the dura. Surgical repair is not necessary in most cases because pseudomeningoceles have a high propensity to spontaneously resolve with conservative management alone. Currently, the...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2018.04.017
更新日期:2018-07-01 00:00:00